1
|
Kautz A, Meng Y, Yeh KL, Peck R, Brunner J, Best M, Fernandez ID, Miller RK, Barrett ES, Groth SW, O'Connor TG. Dietary Intake of Nutrients Involved in Serotonin and Melatonin Synthesis and Prenatal Maternal Sleep Quality and Affective Symptoms. J Nutr Metab 2024; 2024:6611169. [PMID: 39015539 PMCID: PMC11250910 DOI: 10.1155/2024/6611169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 03/15/2024] [Accepted: 06/11/2024] [Indexed: 07/18/2024] Open
Abstract
Poor sleep quality and psychological distress in pregnancy are important health concerns. Serotonin and melatonin levels may underlie variation in these adverse outcomes. In this study, we examined dietary nutrients involved in serotonin and melatonin synthesis in relation to maternal sleep quality and affective symptoms during pregnancy. Pregnant women at no greater than normal medical risk at enrollment completed 24-hour dietary recalls in mid-late pregnancy. Usual intakes of vitamin B6, vitamin D, eicosapentaenoic acid (EPA) + docosahexaenoic acid (DHA), and tryptophan were estimated from dietary intake of foods and supplements using the National Cancer Institute (NCI) method. Sleep quality, depression, and anxiety were measured using validated questionnaires. Associations between nutrient intakes, sleep quality, and affective symptoms were estimated using generalized estimating equation models adjusting for potential confounding factors. In minimally adjusted models, EPA + DHA and tryptophan intakes were associated with a lower score indicating better sleep quality (b: -1.07, 95% CI: -2.09, -0.05) and (b: -12.40, 95% CI: -24.60, -0.21), respectively. EPA + DHA and tryptophan intakes were also associated with a lower odds of shorter sleep duration and sleep disturbances. In addition, tryptophan was associated with a lower odds of higher sleep latency. However, associations were attenuated and nonsignificant after adjustment for demographic and lifestyle factors. In conclusion, intakes of EPA + DHA and tryptophan were associated with improved sleep quality, but these associations were confounded by maternal demographic and lifestyle characteristics. This study highlights the need to consider dietary intake and pregnancy health in the context of demographic characteristics and lifestyle behaviors.
Collapse
Affiliation(s)
- Amber Kautz
- Public Health SciencesUniversity of Rochester Medical Center, Rochester, NY, USA
| | - Ying Meng
- School of NursingUniversity of Rochester Medical Center, Rochester, NY, USA
| | - Kuan-Lin Yeh
- School of NursingUniversity of Rochester Medical Center, Rochester, NY, USA
| | - Robin Peck
- Clinical Research CenterUniversity of Rochester Medical Center, Rochester, NY, USA
| | - Jessica Brunner
- School of NursingUniversity of Rochester Medical Center, Rochester, NY, USA
- Obstetrics and GynecologyUniversity of Rochester Medical Center, Rochester, NY, USA
- PsychiatryUniversity of Rochester Medical Center, Rochester, NY, USA
| | - Meghan Best
- Obstetrics and GynecologyUniversity of Rochester Medical Center, Rochester, NY, USA
| | - I. Diana Fernandez
- Public Health SciencesUniversity of Rochester Medical Center, Rochester, NY, USA
| | - Richard K. Miller
- Obstetrics and GynecologyUniversity of Rochester Medical Center, Rochester, NY, USA
- PediatricsUniversity of Rochester Medical Center, Rochester, NY, USA
- Pathology and Clinical Laboratory MedicineUniversity of Rochester Medical Center, Rochester, NY, USA
- Environmental MedicineUniversity of Rochester Medical Center, Rochester, NY, USA
| | - Emily S. Barrett
- Public Health SciencesUniversity of Rochester Medical Center, Rochester, NY, USA
- Obstetrics and GynecologyUniversity of Rochester Medical Center, Rochester, NY, USA
- Biostatistics and EpidemiologyRutgers School of Public Health, Piscataway, NJ, USA
- Environmental and Occupational Health Sciences InstituteRutgers University, Piscataway, NJ, USA
| | - Susan W. Groth
- School of NursingUniversity of Rochester Medical Center, Rochester, NY, USA
| | - Thomas G. O'Connor
- Obstetrics and GynecologyUniversity of Rochester Medical Center, Rochester, NY, USA
- PsychiatryUniversity of Rochester Medical Center, Rochester, NY, USA
- NeuroscienceUniversity of Rochester Medical Center, Rochester, NY, USA
- PsychologyUniversity of Rochester, Rochester, NY, USA
- Wynne Center for Family ResearchUniversity of Rochester Medical Center, Rochester, NY, USA
| |
Collapse
|
2
|
Kaliush PR, Butner JE, Williams PG, Conradt E, Crowell SE. Dynamic Associations Among Sleep, Emotion Dysregulation, and Desire to Live in a Perinatal Sample. Psychosom Med 2024; 86:272-282. [PMID: 38451838 PMCID: PMC11081831 DOI: 10.1097/psy.0000000000001297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
OBJECTIVE The present study prospectively examined dynamic associations among sleep, emotion dysregulation, and desire to live during the perinatal transition, as it was theorized that these factors may contribute to the emergence of postpartum suicide risk. METHOD Ninety-four women ( Mage = 29.2 years; 23.4% Latina) wore wrist actigraphs and completed twice daily surveys for 7 days during the third trimester of pregnancy, 6 weeks postpartum, and 4 months postpartum. Multilevel, change-as-outcome models were built to examine changes in attractor dynamics among sleep, emotion dysregulation, and desire to live, as well as if sleep-emotion dysregulation dynamics differed based on participants' desires to live. RESULTS From pregnancy to 6 weeks postpartum, emotion dysregulation ( B = -0.09, p = .032) and desire to live ( B = -0.16, p < .001) exhibited more stable temporal patterns around higher emotion dysregulation and lower desire to live. Compared to women who reported consistently high desires to live, those who experienced fluctuations in their desires to live exhibited lower, more stable sleep efficiency during pregnancy ( B = -0.90, p < .001). At 4 months postpartum, those with fluctuating desires to live exhibited a coupling dynamic whereby low sleep efficiency predicted increases in emotion dysregulation ( B = -0.16, p = .020). CONCLUSIONS This study was the first to examine nonlinear dynamics among risk factors for postpartum suicide, which may be evident as early as pregnancy and 6 weeks postpartum. Sleep health, in particular, warrants further exploration as a key susceptibility factor in the emergence of postpartum suicide risk. PREREGISTRATION Open Science Framework ( https://osf.io/qxb75/?view_only=799ffe5c048842dfb89d3ddfebaa420d ).
Collapse
|
3
|
Silveira NC, Balieiro LCT, Gontijo CA, Teixeira GP, Fahmy WM, Maia YCDP, Crispim CA. Association between sleep duration and quality with food intake, chrononutrition patterns, and weight gain during pregnancy. Br J Nutr 2024; 131:1413-1420. [PMID: 38178731 DOI: 10.1017/s0007114523002908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
To analyse the association between sleep duration and quality with food intake, chrononutrition patterns, and weight gain during pregnancy. A prospective cohort study was conducted with 100 pregnant women. Data collection occurred once during each gestational trimester. The assessment of sleep quality and duration was performed using the Pittsburgh Sleep Quality Index. Food intake was assessed using three 24-h recalls in each trimester. Body weight was measured during the three trimesters, and height was measured only once to calculate the BMI. Linear regression analyses were performed to associate sleep duration and quality with food consumption and weight gain variables. Longer sleep duration was associated with a later dinner in the first trimester (β = 0·228, P = 0·025) and earlier in the third trimester (β = -0·223, P = 0·026), in addition to a later morning snack in the second trimester (β = 0·315, P = 0·026). Worse sleep quality was associated with higher total energy intake (β = 0·243, P = 0·044), total fat (β = 0·291, P = 0·015) and the chrononutrition variables such as a higher number of meals (β = 0·252, P = 0·037), higher energetic midpoint (β = 0·243, P = 0·044) and shorter fasting time (β = -0·255, P = 0·034) in the third trimester. Sleep quality was also associated with a higher BMI in the first trimester of pregnancy (β = 0·420, P = < 0·001). Most of the associations found in the present study show that poor sleep is associated with higher energy and fat intake and higher BMI. Longer sleep duration was associated with a later dinner in early pregnancy and an earlier dinner in late pregnancy, as well as with a later morning snack in the second trimester of pregnancy.
Collapse
Affiliation(s)
- Noara Carvalho Silveira
- Chrononutrition Research Group (Cronutri), School of Medicine, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | | | - Cristiana Araújo Gontijo
- Chrononutrition Research Group (Cronutri), School of Medicine, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Gabriela Pereira Teixeira
- Chrononutrition Research Group (Cronutri), School of Medicine, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Walid Makin Fahmy
- Department of Obstetrics, Hospital and Municipal Maternity of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Yara Cristina de Paiva Maia
- Molecular Biology and Nutrition Research Group, School of Medicine, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Cibele Aparecida Crispim
- Chrononutrition Research Group (Cronutri), School of Medicine, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| |
Collapse
|
4
|
Palagini L, Cipriani E, Miniati M, Bramante A, Gemignani A, Geoffroy PA, Riemann D. Insomnia, poor sleep quality and perinatal suicidal risk: A systematic review and meta-analysis. J Sleep Res 2024; 33:e14000. [PMID: 37448156 DOI: 10.1111/jsr.14000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/27/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023]
Abstract
Suicidal risk in mothers is a public health priority. Risk factors include biological, psychological and psychosocial factors. Among the biological factors, the role of sleep disturbances as potential contributors to increased suicidal risk during the peripartum period is becoming apparent. To explore this further, we conducted a systematic review following the PRISMA criteria. Currently, 10 studies have examined the role of insomnia and poor sleep quality in suicidal risk during the peripartum period and have involved 807,760 women. The data showed that disturbed sleep and poor sleep quality increase the risk of suicidal ideation in both pregnant women with and without perinatal depression. The results of the meta-analysis indicated that insomnia and poor sleep quality increase the odds of suicidal risk in pregnant women by more than threefold (OR = 3.47; 95% CI: 2.63-4.57). Specifically, the odds ratio (OR) for poor sleep quality was 3.72 (95% CI: 2.58-5.34; p < 0.001), and for insomnia symptoms, after taking into account perinatal depression, was 4.76 (95% CI: 1.83-12.34; p < 0.001). These findings emphasise the importance of assessing and addressing sleep disturbances during the peripartum period to mitigate their adverse effects on peripartum psychopathology and suicidal risk.
Collapse
Affiliation(s)
- Laura Palagini
- Department of Experimental and Clinical Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Enrico Cipriani
- President of the Italian Section of the Marcè Society for Perinatal Psychopathology, Milan, Italy
| | - Mario Miniati
- Department of Experimental and Clinical Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Alessandra Bramante
- President of the Italian Section of the Marcè Society for Perinatal Psychopathology, Milan, Italy
| | - Angelo Gemignani
- Department of Surgical, Medical, Molecular, and Critical Area Pathology, University of Pisa, Pisa, Italy
| | - Pierre A Geoffroy
- Department of Psychiatry and Addiction, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, Paris, France
- Centre ChronoS, GHU Paris - Psychiatry & Neurosciences, Paris, France
- Université Paris Cité, NeuroDiderot, Inserm, Paris, France
- CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, Strasbourg, France
| | - Dieter Riemann
- Department of Psychiatry and Psychotherapy, Medical Center- University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| |
Collapse
|
5
|
Bete T, Ali T, Misgana T, Negash A, Abraham T, Teshome D, Sirtsu A, Nigussie K, Amano A. Suicidal ideation and associated factors among pregnant women attending antenatal care at public hospitals of Harari regional state, eastern Ethiopia: A cross-sectional study. PLoS One 2024; 19:e0300417. [PMID: 38547179 PMCID: PMC10977762 DOI: 10.1371/journal.pone.0300417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 02/26/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND Suicide is a global issue. It is the third responsible for death among the reproductive age group. Pregnancy is a complicated event and crucial in the life of a woman with considerable physiological, hormonal changes, social, and mental changes. However, third-world countries like Ethiopia have not been investigated well. Therefore, the study planned to assess the magnitude and factors associated with suicidal ideation. Furthermore, it will identify the role of hyperemesis gravidarum on suicidal ideation. METHOD A Cross-sectional study was employed for 543 pregnant participants attending antenatal care at Hiwot Fana Specialized University Hospital and Jugal General Hospital, Harari regional state, eastern Ethiopia from June 1 to August 1, 2022. The recruited participants were selected by systematic random sampling method. Suicide was assessed using Composite International Diagnostic by interview methods data collection. Epi data and STATA version 14.1 were used for data entry and analysis respectively. Candidate variables were entered into a multivariate logistic regression then those variables that have p-value < 0.05 were considered as significantly associated. RESULTS The magnitude of suicidal ideation in this study was found to be 11.15% at (95% CI: 8.75-14.11). Regarding the associated factor, unwanted pregnancy (AOR = 3.39: at 95% CI = 1.58-7.27), Hyperemesis gravidarum (AOR = 3.65: at 95% CI = 1.81-7.34), having depressive symptoms (AOR = 2.79: at 95% CI = 1.49-5.23), having anxiety symptoms (AOR = 3.37; at 95% CI = 1.69-6.68), experiencing intimate partner violence (AOR = 2.88: at 95% CI = 1.11-7.46), and having stress (AOR = 3.46; at 95% CI = 1.75-6.86) were significantly associated variable with suicidal ideation among pregnant women. CONCLUSION AND RECOMMENDATION This study revealed that suicidal ideation is common among pregnant women. Regarding the associated factors unwanted pregnancy, hyperemesis gravidarum, having depressive and anxiety symptoms, experiencing intimate partner violence, and stress were significantly associated with suicidal ideation. Thus, giving awareness and early screening and interferences for antenatal suicide should be warranted.
Collapse
Affiliation(s)
- Tilahun Bete
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tilahun Ali
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tadesse Misgana
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Abraham Negash
- Department of Midwifery, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Teklu Abraham
- Department of Psychiatry, School Medicine, College of Health and Medical Sciences, Arsi University, Assella, Ethiopia
| | - Dekeba Teshome
- Department of Psychiatry, School Medicine, College of Health and Medical Sciences, Arsi University, Assella, Ethiopia
| | - Addisu Sirtsu
- Department of Nursing, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kabtamu Nigussie
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Abdulkerim Amano
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| |
Collapse
|
6
|
Altınayak SÖ, Rüzgar Ş, Koç E. The relationship between sleep problems and sexual dysfunction among pregnant women in Turkey. Sleep Breath 2024; 28:459-465. [PMID: 37550557 DOI: 10.1007/s11325-023-02896-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 07/26/2023] [Accepted: 07/28/2023] [Indexed: 08/09/2023]
Abstract
OBJECTIVE Sexual dysfunction and sleep problems are common in women. Nevertheless, the relationship between sleep problems and sexual dysfunction during pregnancy has yet to be fully clarified. The aim of this study was to evaluate the relationship between sleep problems and sexual dysfunction in pregnant women. METHODS The study had a cross-sectional design and the sample was determined by employing the G*Power program on the basis of the findings of a related study. Taking the correlation value between the Female Sexual Function Index (FSFI) and the Insomnia Severity Index (ISI) into account, it was found that the minimum sample size was 219 pregnant women. Healthy pregnant women who were literate, did not have a diagnosed psychiatric disease, did not have a mental disability or communication problems, were in the gestation period, were not restricted by their doctors in terms of engaging in sexual activity, and who were willing to participate were included. The study included those pregnant women who consecutively attended the NST polyclinic in a maternity hospital in a province in the Black Sea region of Turkey between January 2022 and August 2022. The Sociodemographic Information Form, the Pittsburgh Sleep Quality Index (PSQI), the ISI, and the FSFI were used to collect data. RESULTS A total of 220 pregnant women took part. The women had a mean age of 27.4 ± 6.3. Of the pregnant women, all had poor sleep quality: 61% had insomnia problems; 30% had sexual dysfunction. When the relationships between the PSQI, ISI and FSFI were examined, there was a statistically significant positive correlation between the mean PSQI and ISI scores (p = 0.000). A statistically significant negative correlation was determined between the mean ISI and FSFI scores (p = 0.044). According to the multiple regression analysis, age did not significantly predict sexual function (β = -0.112; t = -1.639; p = 0.103); insomnia severity predicted sexual function negatively (β = -0.146; t = -2.136; p = 0.034). The explained variance was 2.6%. CONCLUSION The findings suggest that sleep quality as measured by the PSQI does not correlate with female sexual dysfunction in pregnant women. However, severity of insomnia does correlate with sexual dysfunction.
Collapse
Affiliation(s)
- Serap Öztürk Altınayak
- Ondokuz Mayıs University Faculty of Health Science, Department of Midwifery, Kurupelit Campus, 55200, Samsun, Turkey.
| | - Şebnem Rüzgar
- Ondokuz Mayıs University Faculty of Health Science, Department of Midwifery, Kurupelit Campus, 55200, Samsun, Turkey
| | - Emine Koç
- Ondokuz Mayıs University Faculty of Health Science, Department of Midwifery, Kurupelit Campus, 55200, Samsun, Turkey
| |
Collapse
|
7
|
Jones AG, Hadaie BS, Bennett R, Kumar N, Saha CK, Haas DM. The Association between Sleep and Depression during Late Pregnancy and the Early Postpartum Period. AJP Rep 2024; 14:e11-e15. [PMID: 38269127 PMCID: PMC10805570 DOI: 10.1055/s-0043-1778003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 10/20/2023] [Indexed: 01/26/2024] Open
Abstract
Objective To assess and correlate sleep quality and depressed mood symptoms in the late pregnancy and early postpartum periods. Study Design In a prospective pilot observational study, participants completed the Pittsburgh Sleep Quality Index (PSQI) and the Edinburgh Postnatal Depression Scale (EPDS) questionnaires at delivery, 1, and 2 months postpartum. Pearson's correlation coefficients and PROC MIXED function estimated overall correlation for repeated measures. Results Twenty-six women were enrolled with a mean gestational age at delivery of 38.4 (± 2.4) weeks. Sleep quality and mood data were available at the three time points for 24, 16, and 11 participants, respectively. Poor sleep scores were noted by 75.0, 87.5, and 72.7% of women at the three time points. An elevated EPDS score of 10 or higher was claimed by 20.8, 12.5, and 18.2% of women, respectively. Higher PSQI scores were positively associated with higher EPDS scores overall ( r = 0.71, p < 0.001) and at each of the individual time points ( r = 0.79, p < 0.0001; r = 0.52, p = 0.04; and r = 0.70, p = 0.016, respectively). None of the women reporting good sleep quality had elevated EPDS scores. Conclusion Poor sleep is commonly reported around delivery, and at 1 and 2 months postpartum, and there is an association between poor sleep and depression symptoms.
Collapse
Affiliation(s)
- Angela G. Jones
- Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Bachar S. Hadaie
- Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Rachel Bennett
- Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Nimisha Kumar
- Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Chandan K. Saha
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana
| | - David M. Haas
- Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, Indiana
| |
Collapse
|
8
|
Zhong W, Zhao A, Lan H, Ren Z, Mao S, Zhang J, Li P, Szeto IMY, Wang P, Zhang Y. Sleep quality, antepartum depression and self-harm thoughts in pregnant Chinese women. J Affect Disord 2023; 327:292-298. [PMID: 36754093 DOI: 10.1016/j.jad.2023.01.127] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 01/27/2023] [Accepted: 01/30/2023] [Indexed: 02/10/2023]
Abstract
BACKGROUND Previous literature has shown a significant association between sleep and depression, whereas limited studies have examined the association of sleep quality with self-harm ideation in pregnant Chinese women. METHODS A total of 898 pregnant women (first to third trimester) from the Young Investigation Study were enrolled in this study. The Pittsburgh Sleep Quality Index (PSQI) questionnaire was used to assess sleep quality. Antepartum depression and self-harm ideation were evaluated using the Edinburgh Postnatal Depression Scale (EPDS). Multivariable logistic regression models were used to calculate odds ratios (ORs) and 95 % confidence intervals (CIs). RESULTS In this sample, the prevalence of poor sleep quality and antepartum depression was 44.3 % and 24.4 %, respectively. Furthermore, 12.8 % of women were considered as having self-harm ideation. Individuals in different trimesters reported similar prevalence of self-harm thoughts. Women were more likely to report self-harm thoughts if they were categorized as poor sleep quality or antepartum depression. And women with moderate or severe depression had higher risk of self-harm ideation and poor sleep, compared with those with mild depression. Although sleep quality indirectly influenced self-harm thoughts through the mediation effect of depressive symptoms, poor sleep quality was still associated with a 2.62-fold increased odds of self-harm ideation among women in the second trimester (OR = 2.62; 95 % CI: 1.11-6.21), after adjustment for depression. LIMITATIONS Causality cannot be inferred. Results should be generalized carefully. Depression was evaluated by a screening tool rather than clinical interviews. CONCLUSIONS The prevalence of poor sleep quality, depressive symptoms and self-harm ideation in pregnant Chinese women were noteworthy and high. Besides, a direct effect was also found between sleep quality and self-harm thoughts among women in the second trimester. Our findings suggest the need to identify and intervene when sleep disturbances are observed in women during pregnancy.
Collapse
Affiliation(s)
- Wuxian Zhong
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China
| | - Ai Zhao
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China
| | - Hanglian Lan
- Inner Mongolia Dairy Technology Research Institute Co., Ltd., Hohhot 010110, China; Yili Maternal and Infant Nutrition Institute, Beijing 100071, China
| | - Zhongxia Ren
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China
| | - Shuai Mao
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China
| | - Jian Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China
| | - Pin Li
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China
| | - Ignatius Man-Yau Szeto
- Inner Mongolia Dairy Technology Research Institute Co., Ltd., Hohhot 010110, China; Yili Maternal and Infant Nutrition Institute, Beijing 100071, China
| | - Peiyu Wang
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing 100191, China
| | - Yumei Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China.
| |
Collapse
|
9
|
Liao S, Wang Y, Zhou X, Zhao Q, Li X, Guo W, Ji X, Lv Q, Zhang Y, Zhang Y, Deng W, Chen T, Li T, Qiu P. Prediction of suicidal ideation among Chinese college students based on radial basis function neural network. Front Public Health 2022; 10:1042218. [PMID: 36530695 PMCID: PMC9751327 DOI: 10.3389/fpubh.2022.1042218] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 11/14/2022] [Indexed: 12/02/2022] Open
Abstract
Background Suicide is one of the leading causes of death for college students. The predictors of suicidal ideation among college students are inconsistent and few studies have systematically investigated psychological symptoms of college students to predict suicide. Therefore, this study aims to develop a suicidal ideation prediction model and explore important predictors of suicidal ideation among college students in China. Methods We recruited 1,500 college students of Sichuan University and followed up for 4 years. Demographic information, behavioral and psychological information of the participants were collected using computer-based questionnaires. The Radial Basis Function Neural Network (RBFNN) method was used to develop three suicidal ideation risk prediction models and to identify important predictive factors for suicidal ideation among college students. Results The incidence of suicidal ideation among college students in the last 12 months ranged from 3.00 to 4.07%. The prediction accuracies of all the three models were over 91.7%. The area under curve scores were up to 0.96. Previous suicidal ideation and poor subjective sleep quality were the most robust predictors. Poor self-rated mental health has also been identified to be an important predictor. Paranoid symptom, internet addiction, poor self-rated physical health, poor self-rated overall health, emotional abuse, low average annual household income per person and heavy study pressure were potential predictors for suicidal ideation. Conclusions The study suggested that the RBFNN method was accurate in predicting suicidal ideation. And students who have ever had previous suicidal ideation and poor sleep quality should be paid consistent attention to.
Collapse
Affiliation(s)
- Shiyi Liao
- Department of Epidemiology and Statistics, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China
| | - Yang Wang
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaonan Zhou
- Department of Epidemiology and Statistics, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China
| | - Qin Zhao
- Department of Epidemiology and Statistics, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China
| | - Xiaojing Li
- Department of Neurobiology and Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Wanjun Guo
- Department of Neurobiology and Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Xiaoyi Ji
- Department of Epidemiology and Statistics, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China
| | - Qiuyue Lv
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Yunyang Zhang
- West China School of Public Health, Sichuan University, Chengdu, Sichuan, China
| | - Yamin Zhang
- Department of Neurobiology and Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Wei Deng
- Department of Neurobiology and Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Ting Chen
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Tao Li
- Department of Neurobiology and Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China,Tao Li
| | - Peiyuan Qiu
- Department of Epidemiology and Statistics, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China,*Correspondence: Peiyuan Qiu
| |
Collapse
|
10
|
Maternal Sleep Problems in the Periconceptional Period and the Impact on Health of Mother and Offspring: A Systematic Review. Clocks Sleep 2022; 4:688-713. [PMID: 36547103 PMCID: PMC9777334 DOI: 10.3390/clockssleep4040052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 11/06/2022] [Accepted: 11/20/2022] [Indexed: 11/27/2022] Open
Abstract
Knowledge of the impact of sleep problems in the periconceptional period is scarce. Since this period is the most sensitive time window for embryonic and placental development, we aim to study the impact of maternal sleep problems in the periconceptional period on both mother and offspring. We systematically searched various databases up until September 2021 for studies reporting on maternal sleep in the periconceptional period and any outcome in mother and offspring. We included observational studies describing maternal sleep problems in the periconceptional period and associations with either maternal and/or offspring outcomes. The search produced 8596 articles, of which we selected 27 studies. Some associations were found between sleep problems and lower fertility, more hypertensive disorders, more mood disorders in mothers, higher risk of preterm birth and low birth weight, and more sleep and behavior problems in offspring, with associations with maternal mood disorders being most consistent. This systematic review shows that maternal sleep problems in the periconceptional period are associated with a higher risk of various adverse outcomes in both mother and offspring, although not consistently. It shows that good sleep during pregnancy is crucial, starting as early as before conception, especially for maternal mood. Therefore, it is important for clinicians to pay attention to sleep problems in the periconceptional period and provide adequate treatment for potential sleep problems, even before pregnancy.
Collapse
|
11
|
Takelle GM, Muluneh NY, Biresaw MS. Sleep quality and associated factors among pregnant women attending antenatal care unit at Gondar, Ethiopia: a cross-sectional study. BMJ Open 2022; 12:e056564. [PMID: 36691143 PMCID: PMC9445783 DOI: 10.1136/bmjopen-2021-056564] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 08/18/2022] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVE This study aimed to determine the prevalence and associated factors of poor sleep quality among pregnant women in Ethiopia. METHOD Institutional based cross-sectional study. SETTING University of Gondar Comprehensive Specialized Hospital, Gondar, Ethiopia. PARTICIPANTS A total of 415 pregnant women were recruited by using a systematic random sampling technique from 28 April 2020 to 12 June 2020. MEASUREMENT The desired data were collected through face-to-face interview technique by using validated questionnaires such as the Pittsburgh Sleep Quality Index, Edinburgh Postnatal Depression Scale, Perceived Stress Scale, Oslo-3 and Abuse Assessment Screen. The data were analysed by using SPSS V.20. Logistic regression analysis was used to identify associated factors with poor sleep quality. Variables having a p value of less than 0.2 in the bivariate analysis were entered to the multivariable logistic regression. A p value of less than 0.05 was considered statistically significant, at 95% CI. RESULT In this study, 175 (42.2%) pregnant women had poor sleep quality. According to multivariable logistic regression, being first and third trimesters of gestational age (adjusted OR (aOR) 2.31, 95% CI 1.16 to 4.61 and aOR 3.45, 95% CI 2.05 to 5.79, respectively), consumption of caffeinated substances (aOR 2.96, 95% CI 1.68 to 5.52), having depression (aOR 2.12, 95% CI 1.19 to 3.76), having high perceived stress (aOR 5.39, 95% CI 1.96 to 14.79) and experience of intimate partner violence (aOR 5.57, 95% CI 2.19 to 14.68) were positive significant associated factors with poor sleep quality. CONCLUSION AND RECOMMENDATION The prevalence of poor sleep quality among pregnant women was relatively high. First and third trimesters, consumption of caffeinated substances, antenatal depression, high perceived stress and intimate partner violence were factors significantly associated with poor sleep quality. This result suggests that all pregnant women should be screened and treated for poor sleep quality during the first and third trimesters.
Collapse
Affiliation(s)
- Girmaw Medfu Takelle
- Department of Psychiatry, University of Gondar College of Medicine and Health Sciences, Gondar, Amhara, Ethiopia
| | - Niguse Yigzaw Muluneh
- Department of Psychiatry, University of Gondar College of Medicine and Health Sciences, Gondar, Amhara, Ethiopia
| | - Mengesha Srahbzu Biresaw
- Department of Psychiatry, University of Gondar College of Medicine and Health Sciences, Gondar, Amhara, Ethiopia
| |
Collapse
|
12
|
Wang Y, Liu H, Zhang C, Li C, Xu JJ, Duan CC, Chen L, Liu ZW, Jin L, Lin XH, Zhang CJ, Zhang HQ, Yu JL, Li T, Dennis CL, Li H, Wu YT. Antepartum sleep quality, mental status, and postpartum depressive symptoms: a mediation analysis. BMC Psychiatry 2022; 22:521. [PMID: 35918689 PMCID: PMC9344627 DOI: 10.1186/s12888-022-04164-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 07/21/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Poor sleep quality and maternal mood disturbances are common during pregnancy and may play pivotal roles in the development of postpartum depression. We aim to examine the trajectories of sleep quality and mental health in women from early pregnancy to delivery and explore the mediating effects of sleep quality and mental status on the link between antepartum depressive symptoms and postpartum depressive symptoms. METHODS In an ongoing prospective birth cohort, 1301 women completed questionnaires in the first, second and third trimesters and at 6 weeks postpartum. In each trimester, sleep quality was measured utilizing the Pittsburgh Sleep Quality Index (PSQI), and mental health was assessed with the Center for Epidemiologic Studies Depression Scale (CES-D), the Self-Rating Anxiety Scale (SAS) and the Perceived Stress Scale (PSS). Postpartum depressive symptoms were evaluated by the Edinburgh Postnatal Depression Scale (EPDS). The bootstrap method was used to test the mediation effect. RESULTS The PSQI, CES-D, and SAS scores presented U-shaped curves across the antenatal period while the PSS score followed a descending trend. Antenatal sleep quality, depressive symptoms, anxiety symptoms and perceived stress all predicted depressive symptoms at 6 weeks postpartum. The influence of antepartum depressive symptoms on postpartum depressive symptoms was mediated by antepartum sleep quality and anxiety symptoms, which accounted for 32.14%, 39.25% and 31.25% in the first, second and third trimesters (P = 0.002, P = 0.001, P = 0.001, respectively). CONCLUSIONS Poor sleep quality and anxiety symptoms in pregnancy mediated the relationship between antepartum depressive symptoms and postpartum depressive symptoms. Interventions aimed at detecting and managing sleep quality and elevated anxiety among depressed women in pregnancy warrant further investigation as preventative strategies for postpartum depression.
Collapse
Affiliation(s)
- Yu Wang
- grid.16821.3c0000 0004 0368 8293School of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910, Hengshan Rd., Shanghai, 200030 China ,grid.16821.3c0000 0004 0368 8293Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, 200030 China
| | - Han Liu
- grid.16821.3c0000 0004 0368 8293School of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910, Hengshan Rd., Shanghai, 200030 China
| | - Chen Zhang
- grid.16821.3c0000 0004 0368 8293School of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910, Hengshan Rd., Shanghai, 200030 China ,grid.8547.e0000 0001 0125 2443Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, 200011 China
| | - Cheng Li
- grid.8547.e0000 0001 0125 2443Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, 200011 China
| | - Jing-Jing Xu
- grid.16821.3c0000 0004 0368 8293School of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910, Hengshan Rd., Shanghai, 200030 China ,grid.16821.3c0000 0004 0368 8293Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, 200030 China
| | - Chen-Chi Duan
- grid.16821.3c0000 0004 0368 8293School of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910, Hengshan Rd., Shanghai, 200030 China ,grid.16821.3c0000 0004 0368 8293Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, 200030 China
| | - Lei Chen
- grid.16821.3c0000 0004 0368 8293School of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910, Hengshan Rd., Shanghai, 200030 China
| | - Zhi-Wei Liu
- grid.16821.3c0000 0004 0368 8293School of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910, Hengshan Rd., Shanghai, 200030 China
| | - Li Jin
- grid.8547.e0000 0001 0125 2443Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, 200011 China
| | - Xian-Hua Lin
- grid.8547.e0000 0001 0125 2443Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, 200011 China
| | - Chen-Jie Zhang
- grid.16821.3c0000 0004 0368 8293School of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910, Hengshan Rd., Shanghai, 200030 China ,grid.16821.3c0000 0004 0368 8293Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, 200030 China
| | - Han-Qiu Zhang
- grid.16821.3c0000 0004 0368 8293School of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910, Hengshan Rd., Shanghai, 200030 China ,grid.16821.3c0000 0004 0368 8293Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, 200030 China
| | - Jia-Le Yu
- grid.16821.3c0000 0004 0368 8293School of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910, Hengshan Rd., Shanghai, 200030 China ,grid.16821.3c0000 0004 0368 8293Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, 200030 China
| | - Tao Li
- grid.16821.3c0000 0004 0368 8293School of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910, Hengshan Rd., Shanghai, 200030 China ,grid.16821.3c0000 0004 0368 8293Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, 200030 China
| | - Cindy-Lee Dennis
- grid.17063.330000 0001 2157 2938Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Hong Li
- School of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910, Hengshan Rd., Shanghai, 200030, China.
| | - Yan-Ting Wu
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, 200011, China. .,Research Units of Embryo Original Diseases, Chinese Academy of Medical Sciences (No. 2019RU056), Shanghai, China.
| |
Collapse
|
13
|
Spanish version of Jenkins Sleep Scale in physicians and nurses: psychometric properties from a Peruvian nationally representative sample. J Psychosom Res 2022; 157:110759. [PMID: 35358746 DOI: 10.1016/j.jpsychores.2022.110759] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 02/02/2022] [Accepted: 02/05/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To evaluate the psychometric properties of the Spanish version of Jenkins Sleep Scale with 4 items (JSS-4) of the Peruvian health system's (PHS) nurses and physicians. METHODS We carried out a psychometric study based on secondary analysis in a sample from a nationally representative survey that used acomplex sampling design. The participants were physicians and nurses aged 18-65 years, working in PHS private and public facilities, who have fulfilled all JSS-4 items. We performed a confirmatory factor analysis. Reliability was evaluated via two estimates - classic alpha (α) and categorical omega (ω) coefficients. Also, we tested the invariance across groups of variables. The convergent validity was evaluated based on the relation between JSS-4 and PHQ-2 using Pearson's correlation coefficient and effect size (Cohen's d). Also, we designed normative values based on percentiles. RESULTS We included 2100 physicians and 2826 nurses in the analysis. We observed that the unidimensional model has adequate goodness-of-fit indices and values of α and ω coefficients. No measurement invariance was found between the groups of professionals and age groups; however, invariance was achieved between sex, monthly income, work-related illness, and chronic illness groups. Regarding the relation with other variables, the JSS-4 has a small correlation with PHQ-2. Also, profession and age-specific normative values were proposed. CONCLUSION JSS-4 Spanish version has adequate psychometric properties in PHS nurses and physicians.
Collapse
|
14
|
Rubio E, Levey EJ, Rondon MB, Friedman L, Sanchez SE, Williams MA, Gelaye B. Poor sleep Quality and Obstructive Sleep Apnea are Associated with Maternal Mood, and Anxiety Disorders in Pregnancy. Matern Child Health J 2022; 26:1540-1548. [PMID: 35596848 DOI: 10.1007/s10995-022-03449-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 04/28/2022] [Accepted: 05/01/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Previous studies suggest sleep quality and obstructive sleep apnea (OSA) may be associated with psychiatric symptoms, including depression, anxiety, and posttraumatic stress disorder (PTSD). However, few studies have examined the relationship between sleep quality and OSA with maternal psychiatric symptoms during pregnancy, a state of vulnerability to these disorders. OBJECTIVE The objective of our study is to examine the association between poor sleep quality and sleep apnea with antepartum depression, anxiety, and PTSD among pregnant women. METHODS A cross-sectional study was conducted among women seeking prenatal care in Lima, Peru. Sleep quality was measured using the Pittsburgh Sleep Quality Index, and the Berlin questionnaire was used to identify women at high risk for OSA. Depression, generalized anxiety, and PTSD symptoms were measured using the Patient Health Questionnaire-9, Generalized Anxiety Disorder Assessment, and PTSD Checklist - Civilian Version. Multivariate logistic regression procedures were used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (95% CI). RESULTS Approximately 29.0X% of women had poor sleep quality, and 6.2% were at high risk for OSA. The prevalence of psychiatric symptoms was high in this cohort with 25.1%, 32.5%, and 30.9% of women reporting symptoms of antepartum depression, antepartum anxiety, and PTSD, respectively. Women with poor sleep quality had higher odds of antepartum depression (aOR = 3.28; 95%CI: 2.64-4.07), generalized anxiety (aOR = 1.94; 95%CI: 1.58-2.38), and PTSD symptoms (aOR = 2.81; 95% CI: 2.28-3.46) as compared with women who reported good sleep quality. Women with a high risk of OSA had higher odds of antepartum depression (aOR = 2.36; 95% CI: 1.57-3.56), generalized anxiety (aOR = 2.02, 95% CI: 1.36-3.00), and PTSD symptoms (aOR = 2.14; 95%CI: 1.43-3.21) as compared with those with a low risk of sleep apnea. CONCLUSIONS Poor sleep quality and high risk of OSA are associated with antepartum depression, generalized anxiety, and PTSD symptoms among pregnant women. Further characterizations of the associations of these prevalent sleep, mood, and anxiety conditions among pregnant women could aid in evaluating and delivering optimal perinatal care to women with these comorbidities.
Collapse
Affiliation(s)
- Elia Rubio
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Elizabeth J Levey
- The Chester M. Pierce, M.D. Division of Global Psychiatry, Massachusetts General Hospital, Boston, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Marta B Rondon
- Department of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Lauren Friedman
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Sixto E Sanchez
- Asociación Civil Proyectos en Salud (PROESA), Lima, Peru.,Universidad Peruana de Ciencias Aplicadas, Lima, Perú
| | - Michelle A Williams
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Bizu Gelaye
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA. .,The Chester M. Pierce, M.D. Division of Global Psychiatry, Massachusetts General Hospital, Boston, MA, USA. .,Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
| |
Collapse
|
15
|
Mediating Role of Mental Resilience between Sleep Quality and Mindfulness Level of Pregnant Women Screened by Prenatal Diagnosis. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:7011836. [PMID: 35126940 PMCID: PMC8816535 DOI: 10.1155/2022/7011836] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 12/28/2021] [Accepted: 01/07/2022] [Indexed: 12/05/2022]
Abstract
Objective To explore the status quo of psychological resilience, mindfulness level, the sleep quality of pregnant women by Prenatal Diagnosis Screening, and the mediating effect of psychological resilience on sleep quality and mindfulness. Methods A survey of 298 pregnant women was conducted using the psychological resilience scale, Pittsburgh sleep quality index, and the concise version of the five-factor mindfulness scale. Results The total score of psychological resilience of pregnant women was (68.96 ± 17.27), mindfulness was (77.25 ± 12.65), the median of total sleep quality was 6, and the detection rate of sleep disorders was 31.9%. The sleep quality of pregnant women was negatively correlated with mindfulness level and psychological resilience (p < 0.01), and mindfulness level was positively associated with psychological resilience (p < 0.01). Bootstrap analysis showed that psychological resilience played an 14.1% mediating role between mindfulness and sleep quality. Conclusion The psychological resilience of pregnant women is low, sleep quality is poor, and mindfulness is mild to moderate. Psychological resilience plays an important role in mediating between mindfulness level and sleep quality that suggests nursing staff should pay attention to and improve the psychological resilience of pregnant women screened by prenatal diagnosis to improve the mindfulness level and sleep quality of pregnant women screened by prenatal diagnosis.
Collapse
|
16
|
O’Brien LM. Sleep in Pregnancy. Respir Med 2022. [DOI: 10.1007/978-3-030-93739-3_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
17
|
Arditi-Arbel B, Hamdan S, Winterman M, Gvion Y. Suicidal ideation and behavior among perinatal women and their association with sleep disturbances, medical conditions, and known risk factors. Front Psychiatry 2022; 13:987673. [PMID: 36741562 PMCID: PMC9893018 DOI: 10.3389/fpsyt.2022.987673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 12/28/2022] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE Suicide is considered one of the leading causes of maternal mortality, especially among women with postpartum depression. In the current systematic review, we conducted a qualitative data synthesis of recent studies exploring novel risk factors including sleep disturbances and medical conditions, alongside known and significant risk factors for perinatal suicidality. EVIDENCE ACQUISITION We conducted a systematic search of the literature according to PRISMA guidelines on PubMed, PsycNET, and Scopus databases. Search terms were "pregnancy" "OR" "postpartum" "OR" "peripartum" "OR" "perinatal" "OR" "postnatal" combined with the Boolean "AND" operator with "suicide" "OR" "suicidality" "OR" "suicidal ideation" "OR" "suicidal behavior." EVIDENCE SYNTHESIS The initial search yielded 1,458 records, of which 51 research reports that met inclusion criteria were analyzed. These 51 studies sampled a total of 45,942 participants. Clinically, sleep disturbance, psychopathology, and social support have been identified as dominant risk factors for suicidal behavior among pregnant and postpartum women, as well as medical conditions and aversive life events. CONCLUSION Monitoring sleep disturbance, depression, and perceived social support is critical given that they are significant risk factors for suicide among perinatal women. Early identification of perinatal women who may be at risk of suicide, although not depressed, is crucial. LIMITATIONS The use of tools designed to identify depression to identify suicidal risk, fail to identify women who are at risk but who do not suffer from depression. Other methodological limitations are the lack of longitudinal studies and the complexity of examining suicidal behavior in sample studies.
Collapse
Affiliation(s)
- Bar Arditi-Arbel
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
| | - Sami Hamdan
- Department of Psychology, The Academic College of Tel Aviv-Yaffo, Tel Aviv-Yafo, Israel
| | - May Winterman
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
| | - Yari Gvion
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
| |
Collapse
|
18
|
Kriengtuntiwong T, Zaw YH, Taneepanichskul N. Brain-Derived Neurotrophic Factor (BDNF) Depression and Subjective Sleep Quality in the First Trimester of Pregnancy Among Migrant Workers in Thailand. J Multidiscip Healthc 2021; 14:2549-2556. [PMID: 34552333 PMCID: PMC8450157 DOI: 10.2147/jmdh.s322355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 09/03/2021] [Indexed: 12/26/2022] Open
Abstract
Introduction Brain-derived neurotrophic factor (BDNF) influences neurodevelopment during pregnancy. Maternal sleep quality and depression are suggested to influence BDNF levels. The objective of this study was to assess the association between depression, sleep quality, and BDNF levels among Myanmar migrant pregnancies. Methods A cross-sectional study was conducted at Krathum Baen Hospital, Samut Sakhon province, from June to October 2018. A total of 108 first-trimester women were recruited into our study. Maternal blood was collected to analyze BDNF. Depression levels were assessed using the Patient Health Questionnaire (PHQ-9) instrument. The Pittsburgh Sleep Quality Index (PSQI) questionnaire was applied to evaluate subjective sleep quality. Because BDNF was skewed, binary logistic regression was analyzed. Results We found that 28.7% of pregnant women reported poor sleep quality, and 33.4% were classified as having mild to moderate depression. After adjusting for covariate variables, pregnant women with depression had higher BDNF levels than those without depression (OR = 2.972, 95% CI = [1.111, 7.949], p = 0.030). Pregnant women with poor sleep quality had lower BDNF levels than those who had good sleep quality (OR = 0.359, 95% CI = [0.132, 0.972], p = 0.044). Discussion The results suggested that BDNF might be an alternative tool to assess sleep quality in pregnant women.
Collapse
Affiliation(s)
- Thuvachit Kriengtuntiwong
- College of Public Health Science, Chulalongkorn University, Bangkok, Thailand.,Department of Mental Health, Srithanya Hospital, Nonthaburi, Thailand
| | - Ye Htet Zaw
- Defense Services Medical Academy, Yangon, Myanmar
| | - Nutta Taneepanichskul
- College of Public Health Science, Chulalongkorn University, Bangkok, Thailand.,HAUS IAQ Research Unit, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| |
Collapse
|
19
|
Anbesaw T, Negash A, Mamaru A, Abebe H, Belete A, Ayano G. Suicidal ideation and associated factors among pregnant women attending antenatal care in Jimma medical center, Ethiopia. PLoS One 2021; 16:e0255746. [PMID: 34432799 PMCID: PMC8386870 DOI: 10.1371/journal.pone.0255746] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 07/22/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Suicidal ideation (SI) among pregnant women is a major public health concern worldwide and is associated with a higher risk of completed suicide. However, there are limited studies that determined the prevalence and the potential determinants of suicidal ideation in Sub-Saharan Africa, including Ethiopia. Therefore, this study aimed to explore the prevalence of suicidal ideation and associated factors among pregnant women attending antenatal care in Jimma, Ethiopia. METHODS An institutional-based cross-sectional study was conducted among 423 pregnant women attending Jimma medical center in Southwest, Ethiopia. A systematic random sampling technique was used to select the study participants. Suicidal ideation assessed using the Suicidality Module of the World Mental Health survey initiative version of the World Health Organization Composite International Diagnostic Interview (CIDI). Other tools used are EPDS, Abuse Assessment Scale (AAS), DASS -21, PSS, Maternity Social Support Scale (MSSS), and Pittsburgh Sleep Quality Index (PSQI). A multivariable logistic regression analysis was used to explore the potential determinants of suicidal ideation among the participants. RESULT The prevalence of SI among women who are on antenatal care was found to be 13.3% (95% CI (10.1,16.4). In multivariable analysis, marital status with lack of cohabiting partners (AOR = 2.80,95%CI:1.23,6.37), history of abortion (AOR = 2.45,95% CI:1.03,5.93), having depression (AOR = 4.28,95% CI:1.75,10.44),anxiety(AOR = 2.99,95% CI:1.24,7.20), poor sleep quality (AOR = 2.85,95% CI:1.19,6.79), stress (AOR = 2.50, 95% CI:1.01,5.67), and intimate partner violence (AOR = 2.43, 95% CI:1.07,5.47) were found to be significant predictors of suicidal ideation. CONCLUSION The prevalence of SI among pregnant women was found to be huge. Lack of cohabiting partners, previous history of abortion, depression, anxiety, intimate partner violence, poor sleep quality, and stress were variables that are independent predictors of suicidal ideation. Screening and interventions of antenatal SI are needed.
Collapse
Affiliation(s)
- Tamrat Anbesaw
- Department of Psychiatry, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Alemayehu Negash
- Department of Psychiatry, Institute of Health Sciences, Faculty of Medical Science, Jimma University, Jimma, Ethiopia
| | - Almaz Mamaru
- Department of Psychiatry, Faculty of Medical Science, Institute of Health Sciences, Jimma University, Jimma, Ethiopia
| | - Habtamu Abebe
- Department of Epidemiology and Biostatistics, Faculty of Medical Science, Institute of Health Sciences, Jimma University, Jimma, Ethiopia
| | - Asmare Belete
- Department of Psychiatry, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Getinet Ayano
- Research and Training Department, Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia
- School of Public Health, Curtin University, Bentley, Australia
| |
Collapse
|
20
|
Cunningham JEA, Qureshi AR, Green SM, Frey BN, Slyepchenko A. Sleep, biological rhythms and anxiety in the perinatal period: a systematic review protocol. BMJ Open 2021; 11:e046767. [PMID: 34376446 PMCID: PMC8356167 DOI: 10.1136/bmjopen-2020-046767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Pregnancy and new parenthood is an exciting time, but also a stressful life event that can predispose to mental health challenges. Perinatal anxiety is one such challenge, and is an important contributor to parental distress and other negative outcomes. Sleep and biological rhythms are often disrupted in the perinatal period. These disruptions have been associated with postpartum depression, and in some cases with perinatal anxiety. However, the literature concerning the association with perinatal anxiety is inconsistent and may be methodologically limited. To our knowledge, there has been no comprehensive review published characterising the relationships between sleep, biological rhythms, and perinatal anxiety and related disorders to date. In this systematic review, we will summarise the current state of the literature concerning these relationships, allowing us to highlight gaps and potentially inform clinical understanding of perinatal anxiety, sleep and biological rhythms. METHODS AND ANALYSIS Primary research articles will be eligible for inclusion if they assess perinatal anxiety or related disorders using validated criteria (self-report or diagnostic), assess sleep and biological rhythms in the perinatal period, include >4 participants and meet other inclusion/exclusion criteria. We will conduct comprehensive searches of MEDLINE, PsycINFO, Embase and CINAHL, with coverage spanning from database conception to search date (August 1, 2021). Key search concepts include (1) the perinatal period, (2) sleep/biological rhythms and (3) anxiety. Risk of bias will be evaluated using the Cochrane Risk of Bias Tool. Data will be narratively synthesised, with quantitative synthesis included if possible. When relevant, strength of evidence will be assessed using Grading of Recommendations Assessment, Development and Evaluation criteria, and potential publication bias will be assessed. ETHICS AND DISSEMINATION Research ethics approval is not required. Study results will be reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results will be disseminated to relevant stakeholders as conference presentation(s) and submitted for publication in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER 200166.
Collapse
Affiliation(s)
- Jasmyn E A Cunningham
- Michael G DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Aljeena R Qureshi
- Health Sciences Honours Program, McMaster University, Hamilton, Ontario, Canada
| | - Sheryl M Green
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Women's Health Concerns Clinic, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Benicio N Frey
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Women's Health Concerns Clinic, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
- Mood Disorders Program, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Anastasiya Slyepchenko
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| |
Collapse
|
21
|
Kadıoğlu N, Sert UY, Sariaslan SG, Mursel K, Celen S. Sleep Disorders in Pregnancy, Influencing Factors and Quality of Life. Z Geburtshilfe Neonatol 2021; 226:34-40. [PMID: 34311492 DOI: 10.1055/a-1519-7517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AIM In our study, the frequency of sleep disturbances in pregnancy, the reasons underlying the low quality of sleep, clinical factors, and the effects on quality of life were investigated. METHODS The study was planned as a prospective study and included 189 pregnant women. Clinical features, laboratory results, socio-demographic status, obstetric and medical anamnesis were evaluated. The Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, the Berlin Questionnaire, Beck Depression Inventory, SF-36 quality-of-life questionnaire, and restless leg syndrome (RLS) diagnosis criteria were used for data collection. RESULTS We investigated sleep disorders in 110 pregnant women (58.2%). A history of premenstrual syndrome and patients with hyperemesis gravidarum, obstructive sleep apnea syndrome, Vitamin B12 deficiency, and higher TSH levels in the laboratory were found to be associated with sleep disorders. Sleep disorders and daytime sleepiness were associated with depression, physical and social functioning, pain, and disturbance in general health perception. The number of pregnant women who had two or more RLS complaints was 84 (44%). CONCLUSION The results of our study show that sleep disorders in pregnancy can be managed with easily applicable methods according to the risk factors and related problems.
Collapse
Affiliation(s)
- Nezaket Kadıoğlu
- Department of Obstetrics and Gynecology, University of Yuksek ihtisas, Ankara, Turkey
| | - Umit Yasemin Sert
- Department of Obstetrics and Gynecology, Ankara City Hospital, Cankaya, Ankara
| | | | - Konul Mursel
- Department of Obstetrics and Gynecology, Lokman Hekim Hospital, Ankara, Turkey
| | - Sevki Celen
- Department of Obstetrics and Gynecology, Etlik Zubeyde Hanim Education and Research Hospital, Ankara, Turkey
| |
Collapse
|
22
|
Pauley AM, Moore GA, Mama SK, Molenaar P, Symons Downs D. Associations between prenatal sleep and psychological health: a systematic review. J Clin Sleep Med 2021; 16:619-630. [PMID: 32003734 DOI: 10.5664/jcsm.8248] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
STUDY OBJECTIVES This systematic review aimed to examine the: (1) strength of associations between prenatal sleep (ie, duration, quality, and insomnia) and psychological health (ie, depression, anxiety, and stress); and (2) moderating influence of sociodemographic characteristics (ie, maternal age, gestational age/trimester, parity, marital and socioeconomic status [SES]), body mass index (BMI), and meeting sleep recommendations. METHODS A systematic search was conducted using PubMed, PsycINFO, Web of Science, and CINHAL to identify studies with at least one sleep measure and a psychological health outcome. Effect sizes (ES) were calculated by associations between individual components of sleep and psychological health (eg, sleep quality-depression). RESULTS Reviewed studies (n = 32) included 14,648 participants and yielded 219 ES. ES for anxiety/stress were combined due to insufficient data to analyze individually. Average strengths of associations for sleep duration-depression (ES = .52) and sleep duration-anxiety/stress (ES = .48), sleep quality-depression (ES = .55) and sleep quality-anxiety/stress (ES = .58), and insomnia-depression (ES = .67) ranged from medium to large. Marital status, parity, BMI, and meeting sleep recommendations moderated sleep duration-depression and sleep duration-anxiety/stress. SES, gestational age/trimester, parity, and BMI moderated sleep quality-depression and sleep quality-anxiety/stress associations. CONCLUSIONS Poor sleep quality and depression are prevalent during pregnancy and may negatively impact maternal and fetal outcomes. Moderating effects suggest that pregnant women of different BMI status and gestational age differ in their sleep habits and depression and anxiety/stress levels. Findings highlight the need to better understand the impact of these associations on maternal-fetal outcomes to inform interventions to improve sleep and psychological health.
Collapse
Affiliation(s)
- Abigail M Pauley
- Exercise Psychology Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania
| | - Ginger A Moore
- Department of Psychology, The Pennsylvania State University, University Park, Pennsylvania
| | - Scherezade K Mama
- Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania
| | - Peter Molenaar
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, Pennsylvania
| | - Danielle Symons Downs
- Exercise Psychology Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania.,Department of OBGYN, College of Medicine, Hershey, Pennsylvania
| |
Collapse
|
23
|
Conlon RPK, Wang B, Germeroth LJ, Cheng Y, Buysse DJ, Levine MD. Demographic, Pregnancy-Related, and Health-Related Factors in Association with Changes in Sleep Among Pregnant Women with Overweight or Obesity. Int J Behav Med 2021; 28:200-206. [PMID: 32378048 DOI: 10.1007/s12529-020-09887-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Women with prepregnancy overweight/obesity are at high risk for obstetric complications and cardiometabolic disease. Poorer sleep quality is associated with obesity in non-pregnant individuals and, during pregnancy, poor sleep predicts negative obstetric and health outcomes. This study examined sleep patterns among women with overweight/obesity and factors associated with different sleep trajectories during pregnancy. METHODS Women (N = 146, 17-40 years old) with a prepregnancy body mass index ≥ 25 kg/m2 were recruited during early pregnancy. Participants reported demographic information and completed the Pittsburgh Sleep Quality Index (PSQI) at up to six monthly assessments, with the first assessment occurring between 12 and 20 weeks gestation and the final assessment between 35 weeks gestation and delivery. PSQI scores > 5 indicate "poor sleep." RESULTS On average, women's PSQI scores were 6.66 ± 3.58 in the first half of pregnancy and were significantly higher (worse) at the end of pregnancy (t(644) = 4.55, p < 0.001), with the greatest change occurring in the third trimester (t(636.3) = 3.72, p < 0.001). Women who currently smoked had poorer sleep than women who did not currently smoke (t(1) = 2.29, p = 0.02). Prepregnancy weight status, age, parity, race, education, and income were not significantly associated with sleep changes (t(1) < 1.76, ps > 0.08). The percentage of women with PSQI scores > 5 (the threshold for poor sleep quality) was 37-63% across assessments, with the greatest increase occurring during the third trimester (t(633) = 2.92, p = 0.004). CONCLUSIONS Sleep quality worsens during the third trimester and is associated with current smoking. Future studies of sleep during pregnancy should examine health outcomes among women with overweight/obesity and early intervention to mitigate sleep disturbances as pregnancy progresses.
Collapse
Affiliation(s)
- Rachel P Kolko Conlon
- Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara Street, Pittsburgh, PA, 15213, USA.
| | - Bang Wang
- Department of Statistics, University of Pittsburgh, Pittsburgh, PA, USA
| | - Lisa J Germeroth
- Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara Street, Pittsburgh, PA, 15213, USA
| | - Yu Cheng
- Department of Statistics, University of Pittsburgh, Pittsburgh, PA, USA
| | - Daniel J Buysse
- Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara Street, Pittsburgh, PA, 15213, USA
| | - Michele D Levine
- Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara Street, Pittsburgh, PA, 15213, USA
| |
Collapse
|
24
|
Nocturnal cognitive hyperarousal, perinatal-focused rumination, and insomnia are associated with suicidal ideation in perinatal women with mild to moderate depression. Sleep Med 2021; 81:439-442. [PMID: 33839373 DOI: 10.1016/j.sleep.2021.03.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 02/23/2021] [Accepted: 03/05/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVES This prospective study explored associations among insomnia, nocturnal cognitive hyperarousal, and nocturnal perinatal-focused rumination with suicidal ideation (SI) in perinatal women with depression. METHODS From late pregnancy through early postpartum, 39 depressed women completed 17 weekly surveys assessing SI, insomnia, depression, stress, and cognitive arousal. RESULTS Women with nocturnal cognitive hyperarousal at baseline, relative to those with low cognitive arousal, were at greater risk for new onset SI (33% vs 1%). Moreover, nocturnal perinatal-focused rumination was independently associated with SI. SI-risk was highest when women reported clinical insomnia combined with nocturnal cognitive hyperarousal (OR = 5.66, p = 0.037) or perinatal-focused rumination (OR = 11.63, p = 0.018). Daytime perseverative thinking was not uniquely associated with SI. CONCLUSIONS Nocturnal cognitive arousal predicts the development of new onset SI, and perinatal-focused rumination is also uniquely associated with SI-risk in late pregnancy and early parenting. Critically, SI-risk is highest when perinatal women endorsed insomnia and high cognitive arousal at the same time. Future research should determine whether alleviating nocturnal cognitive arousal, pregnancy- and fetal/infant-related concerns, and insomnia with psychotherapy reduces SI for women with perinatal depression.
Collapse
|
25
|
Shen WC, Chen CH. Effects of non-supervised aerobic exercise on sleep quality and maternal-fetal attachment in pregnant women: A randomized controlled trial. Complement Ther Med 2021; 57:102671. [PMID: 33486048 DOI: 10.1016/j.ctim.2021.102671] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 11/19/2020] [Accepted: 01/15/2021] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES This study was designed to evaluate the effect in pregnant women of a non-supervised aerobic exercise intervention on sleep quality and maternal-fetal attachment. DESIGN Pretest-posttest randomized controlled trial. SETTING Prenatal clinic of a medical center in southern Taiwan. PARTICIPANTS One hundred and forty eligible, pregnant women were assigned systematically, at a random starting point, to either the experimental group (n = 70) or the control group (n = 70). INTERVENTION Participants in the experimental group received a 20-minute, low-impact aerobic exercise video on DVD and were instructed to exercise at home at least three times per week for a period of three months. Participants in the control group received routine prenatal care only. MAIN OUTCOME MEASURES The Pittsburgh Sleep Quality Index and Modified Maternal-Fetal Attachment Scale were used to assess outcome measures before the intervention and at four and 12-weeks post-intervention. RESULTS The paired-sample t-tests revealed a significant improvement in sleep quality in the experimental group at 4-weeks posttest, which persisted through 12-weeks posttest. In addition, the experimental group reported a significantly higher mean score for maternal-fetal attachment at 4-weeks posttest than the control group. CONCLUSION The results of this study indicate that performing aerobic exercise ameliorates the decline in sleep quality and improves maternal-fetal attachment in women who are pregnant. These findings may be used to encourage pregnant women to regularly perform low-impact aerobic exercise.
Collapse
Affiliation(s)
- Wen-Chun Shen
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, and Case Manager, Department of Neurology, National Cheng Kung University Hospital, Tainan, Taiwan.
| | - Chung-Hey Chen
- Department of Nursing, Hungkuang University, Taichung, and Adjunct Professor, Department of Nursing & Institute of Allied Health Sciences, National Cheng Kung University, Tainan, Taiwan.
| |
Collapse
|
26
|
Bao C, Xu L, Tang W, Sun S, Zhang W, He J, Zhao K, Xu D, Ye X. Poor Sleep and Decision-Making Disturbance Are Associated With Suicidal Ideation in Pre-natal Depression. Front Psychiatry 2021; 12:680890. [PMID: 34122192 PMCID: PMC8193041 DOI: 10.3389/fpsyt.2021.680890] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 05/03/2021] [Indexed: 12/25/2022] Open
Abstract
Although many risk factors for suicidal ideation have been identified, few studies have focused on suicidal ideation and pre-natal depression. The purpose was to investigate the relationship between decision-making (DM) dysfunction and sleep disturbance on suicidal ideation in pre-natal depression. Participants included 100 women in the third trimester of pregnancy, including pregnant women with pre-natal depression who had recent suicidal ideation (n = 30), pre-natal depression without SI (n = 35) and healthy controls (n = 35). The Iowa Gambling Task (IGT) was used to evaluate the DM function and the Pittsburgh Sleep Quality Index (PSQI) was used to assess the sleep index. The Edinburgh Post-natal Depression Scale (EPDS) was used to assess suicidal ideation and the seriousness of depression. Overall, the two groups with pre-natal depression showed worse sleep quality and decreased DM function compared with healthy controls. The pre-natal depression with suicidal ideation group showed a significantly higher score in subjective sleep quality and a lower score in block 5 of IGT than the pre-natal depression without suicidal ideation group. Further correlation analysis showed that suicidal ideation positively correlated with subjective sleep quality, sleep duration, and daytime function, and negatively correlated with IGT scores. Sleep disturbance and impaired DM function may be risk factors for suicidal ideation in pre-natal depression.
Collapse
Affiliation(s)
- Ciqing Bao
- Wenzhou Seventh People's Hospital, Wenzhou, China
| | - Ling Xu
- Wenzhou Seventh People's Hospital, Wenzhou, China
| | - Weina Tang
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Shiyu Sun
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Wenmiao Zhang
- Department of Obstetrics, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jincai He
- Department of Neurology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Ke Zhao
- The Affiliated Kangning Hospital of Wenzhou Medical University, Wenzhou, China
| | - Dongwu Xu
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Xiaodan Ye
- The Affiliated Kangning Hospital of Wenzhou Medical University, Wenzhou, China
| |
Collapse
|
27
|
Liu H, Li H, Li C, Chen L, Zhang C, Liu Z, Wu Y, Huang H. Associations between Maternal Sleep Quality Throughout Pregnancy and Newborn Birth Weight. Behav Sleep Med 2021; 19:57-69. [PMID: 31830816 DOI: 10.1080/15402002.2019.1702551] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: Poor sleep quality is common during pregnancy. Although a few studies have investigated the associations between maternal sleep quality and fetal birth weight (BW), no evidence has been clearly demonstrated. Our aim was to investigate the effects of sleep quality during pregnancy on the newborn BW z-scores. Participants: 1466 mother-infant pairs were included in the present study based on an ongoing prospective cohort. Methods: Questionnaires including the Pittsburgh Sleep Quality Index (PSQI) and scales for psychosocial status were administered at each trimester. BW z-scores were calculated based on the INTERGROWTH-21st standard. A generalized estimating equation model was applied to evaluate the associations between trimester-specific sleep quality and newborn BW after adjusting for potential confounders. Multivariable logistic regression models were applied to examine the impacts of maternal sleep quality on small-for-gestational-age (SGA) or low birth weight (LBW). Results: We found that maternal PSQI scores in the first and third trimesters were negatively associated with BW z-scores among female newborns (β = -0.032, 95% CI: -0.063, -0.001, P= .043; β = -0.031, 95% CI: -0.060, -0.003, P= .033, respectively). However, no relationship was observed between maternal sleep quality and BW in male neonates. Additionally, poor sleep quality in late pregnancy was a risk factor for LBW (OR = 1.501, 95% CI: 1.082-2.082). Conclusions: The BW z-scores of female newborns decreased as maternal sleep quality in the first and third trimesters worsened. This finding suggests that sleep during pregnancy may influence fetal weight in a trimester- and gender-specific manner.
Collapse
Affiliation(s)
- Han Liu
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University , Shanghai, China.,Shanghai Key Laboratory of Embryo Original Diseases , Shanghai, China.,Shanghai Municipal Key Clinical Specialty , Shanghai, China
| | - Hong Li
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University , Shanghai, China.,Shanghai Key Laboratory of Embryo Original Diseases , Shanghai, China.,Shanghai Municipal Key Clinical Specialty , Shanghai, China
| | - Cheng Li
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University , Shanghai, China.,Shanghai Key Laboratory of Embryo Original Diseases , Shanghai, China.,Shanghai Municipal Key Clinical Specialty , Shanghai, China
| | - Lei Chen
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University , Shanghai, China.,Shanghai Key Laboratory of Embryo Original Diseases , Shanghai, China.,Shanghai Municipal Key Clinical Specialty , Shanghai, China
| | - Chenjie Zhang
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University , Shanghai, China.,Shanghai Key Laboratory of Embryo Original Diseases , Shanghai, China.,Shanghai Municipal Key Clinical Specialty , Shanghai, China
| | - Zhiwei Liu
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University , Shanghai, China.,Shanghai Key Laboratory of Embryo Original Diseases , Shanghai, China.,Shanghai Municipal Key Clinical Specialty , Shanghai, China
| | - Yanting Wu
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University , Shanghai, China.,Shanghai Key Laboratory of Embryo Original Diseases , Shanghai, China.,Shanghai Municipal Key Clinical Specialty , Shanghai, China
| | - Hefeng Huang
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University , Shanghai, China.,Shanghai Key Laboratory of Embryo Original Diseases , Shanghai, China.,Shanghai Municipal Key Clinical Specialty , Shanghai, China
| |
Collapse
|
28
|
Suicidal ideation among nurses: Unique and cumulative effects of different subtypes of sleep problems. J Affect Disord 2020; 276:600-607. [PMID: 32871691 DOI: 10.1016/j.jad.2020.07.095] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 06/10/2020] [Accepted: 07/05/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Nurses have high rates of sleep problems, and higher risk of suicide than the general population. However, there is no empirical evidence showing the extent to which sleep problems among nurses are related to suicidal ideation. METHODS Multistage stratified cluster sampling was performed to recruit nurses from tertiary hospitals in Shandong, China. Item 9 of the Patient Health Questionnaire-9 was used to assess suicidal ideation. The Pittsburgh Sleep Quality Index was used to assess different subtypes of sleep problems. RESULTS Overall prevalence of suicidal ideation among the sample was 10.8%. Nurses with sleep problems were at high risk for suicidal ideation (bOR = 1.79, 95% CI = 1.20-2.65). Among different sleep problem subtypes, only "cannot breathe comfortably" was independently related to suicidal ideation. Different subtypes of sleep problems had cumulative effects on suicidal ideation: the more subtypes of sleep problems nurses experienced, the higher the likelihood of suicidal ideation. LIMITATIONS The cross-sectional study design prevents inferring causation, and the use of self-report measures may lead to recall bias. Other physical/mental conditions, besides depression, were not assessed. Statistical power may have been insufficient due to the small sub-sample who reported suicidal ideation. Also, the generalizability of the results is limited, as the sample only comprised nurses in tertiary hospitals. CONCLUSIONS Nurses experiencing sleep problems were associated with increased likelihood of suicidal ideation. It may be beneficial to incorporate sleep problems into routine screening and intervention for suicide prevention in clinical practice.
Collapse
|
29
|
Friedman LE, Gelaye B, Sanchez SE, Williams MA. Association of social support and antepartum depression among pregnant women. J Affect Disord 2020; 264:201-205. [PMID: 32056751 DOI: 10.1016/j.jad.2019.12.017] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 12/09/2019] [Accepted: 12/13/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Few investigators have evaluated the association between early pregnancy social support and depression; however, increased social support may improve mental health during pregnancy. Our objective is to examine whether in early pregnancy there is an association between social support and maternal depression among women in Peru. METHODS 2,062 pregnant women participated in structured interviews. Early pregnancy social support was measured using the Social Support Questionnaire (SSQ-6). We evaluated the number of individuals that participants could turn to in different situations (Social Support Number Score; SSQN) and their satisfaction with support received (Social Support Satisfaction Score; SSQS). Median SSQN and SSQS characterized participants according to high and low levels of support. SSQN family vs. non-family support were also evaluated separately. Antepartum depression was assessed using the Patient Health Questionnaire-9. Multivariable logistic regression procedures were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS 39.6% of women reported high SSQN and 45.5% reported high SSQS. Approximately 25% had antepartum depression. Women with high SSQN had 22% lower odds of antepartum depression (OR = 0.78; 95%CI: 0.63-0.97). Similarly, women with high SSQS scores had 45% lower odds of antepartum depression (OR = 0.55; 95%CI: 0.45-0.68). Women with high SSQN non-family scores had 30% lower odds antepartum depression compared to those with low SSQN non-family scores (OR = 0.70; 95%CI: 0.57-0.86). The association between SSQN family scores and antepartum depression did not reach statistical significance. CONCLUSION Increased social support may improve maternal mental health during pregnancy and this association should be assessed in longitudinal studies.
Collapse
Affiliation(s)
- Lauren E Friedman
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, United States.
| | - Bizu Gelaye
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Sixto E Sanchez
- Universidad Peruana de Ciencias Aplicadas, Lima, Peru; Asociación Civil PROESA, Lima, Peru
| | - Michelle A Williams
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| |
Collapse
|
30
|
Yang Y, Li W, Ma TJ, Zhang L, Hall BJ, Ungvari GS, Xiang YT. Prevalence of Poor Sleep Quality in Perinatal and Postnatal Women: A Comprehensive Meta-Analysis of Observational Studies. Front Psychiatry 2020; 11:161. [PMID: 32231599 PMCID: PMC7082815 DOI: 10.3389/fpsyt.2020.00161] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 02/20/2020] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Sleep disturbance is common in perinatal and postnatal women, but the epidemiology of sleep problems is highly variable in these populations. This was a meta-analysis that examined the prevalence of poor sleep quality and its correlates among perinatal and postnatal women. METHODS A systematic search of both international and Chinese databases (PubMed, EMBASE, PsycINFO, Web of Science, CNKI, and Wangfang) was performed. Studies with data on sleep quality measured by the Pittsburgh Sleep Quality Index (PSQI) were included. RESULTS Forty-two studies were included for analyses. The prevalence of poor sleep quality was 54.2% (95% CI: 47.9-60.5%) in perinatal and postnatal women, with 44.5% (95% CI: 37.6-51.6%) in perinatal women and 67.2% (95% CI: 57.6-75.5%) in postnatal women. The pooled total PSQI score was 7.54 ± 0.40 (95% CI: 6.75-8.33), while the average PSQI component scores varied from 0.13 ± 0.04 for use of sleeping medication to 1.51 ± 0.17 for habitual sleep efficiency. Maternal age, study site, survey year, comorbidity, PSQI cut-off value, and quality assessment score had significant moderating effects on the prevalence of poor sleep quality. CONCLUSION Given the negative impact of poor sleep quality on health outcomes and well-being, regular screening for poor sleep quality and effective interventions should be conducted for this population.
Collapse
Affiliation(s)
- Yuan Yang
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macau, China.,Center for Cognition and Brain Sciences, University of Macau, Macau, China.,Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, Guangdong, China
| | - Wen Li
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macau, China.,Center for Cognition and Brain Sciences, University of Macau, Macau, China
| | - Tian-Jiao Ma
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Ling Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Brian J Hall
- Global and Community Mental Health Research Group, Department of Psychology, University of Macau, Macau, China
| | - Gabor S Ungvari
- Division of Psychiatry, School of Medicine, University of Western Australia, Perth, WA, Australia.,The University of Notre Dame Australia, Fremantle, WA, Australia
| | - Yu-Tao Xiang
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macau, China.,Center for Cognition and Brain Sciences, University of Macau, Macau, China
| |
Collapse
|
31
|
The Mediating Effect of Sleep Quality on the Relationship between Emotional and Behavioral Problems and Suicidal Ideation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16244963. [PMID: 31817688 PMCID: PMC6949910 DOI: 10.3390/ijerph16244963] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 12/02/2019] [Accepted: 12/04/2019] [Indexed: 12/23/2022]
Abstract
Emotional and behavioral problems in adolescents are associated with suicidal ideation, but different dimensions of problems may be associated with different levels of suicidal ideation. The aim of this large-scale study was to explore the relationship between different dimensions of emotional and behavioral problems and suicidal ideation in Chinese adolescents and to determine whether sleep disorders play a mediating role in the relationship. In total, 20,475 students completed the questionnaire regarding emotional and behavioral problems, sleep quality and suicidal ideation. After adjustment for covariates, total emotional and behavioral difficulties (adjusted odds ratios (AOR) = 1.22, 95% confidence interval (CI) = 1.21-1.23) and sleep disorders (AOR = 4.17, 95% CI = 3.82-4.54) increased the risk of suicidal ideation, while prosocial problems (AOR = 0.91, 95% CI = 0.90-0.93) decreased the risk of suicidal ideation. Sleep quality partially mediated the relationship between emotional and behavioral problems and suicidal ideation. The standardized indirect effects of emotional and behavioral difficulties on suicidal ideation (standardized β estimate = 0.031, 95% CI = 0.020, 0.044) and the effects of prosocial problems on suicidal ideation (standardized β estimate = -0.039, 95% CI = -0.045, -0.035) mediated by sleep quality were statistically significant (p < 0.001). Our study indicates that emotional and behavioral problems increase the risk of suicidal ideation. Additionally, sleep quality plays a mediating role in the association between emotional and behavioral problems and suicidal ideation.
Collapse
|
32
|
Kalmbach DA, Cheng P, Ong JC, Ciesla JA, Kingsberg SA, Sangha R, Swanson LM, O'Brien LM, Roth T, Drake CL. Depression and suicidal ideation in pregnancy: exploring relationships with insomnia, short sleep, and nocturnal rumination. Sleep Med 2019; 65:62-73. [PMID: 31710876 DOI: 10.1016/j.sleep.2019.07.010] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 07/03/2019] [Accepted: 07/09/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Sleep problems and depression are highly prevalent in pregnancy. Nocturnal rumination has been linked to insomnia and depression in non-pregnant samples, but remains poorly characterized in pregnancy. This study explored relationships of depression and suicidal ideation with insomnia, short sleep, and nocturnal rumination in mid-to-late pregnancy. METHODS In this study, 267 pregnant women were recruited from obstetric clinics and completed online surveys on sleep, depression, and nocturnal rumination. RESULTS Over half (58.4%) of the sample reported clinical insomnia on the Insomnia Severity Index, 16.1% screened positive for major depression on the Edinburgh Postnatal Depression Scale (EPDS), and 10.1% endorsed suicidal ideation. Nocturnal rumination was more robustly associated with sleep onset difficulties than with sleep maintenance issues. Depressed women were at greater odds of sleep onset insomnia (OR = 2.80), sleep maintenance insomnia (OR = 6.50), high nocturnal rumination (OR = 6.50), and negative perinatal-focused rumination (OR = 2.70). Suicidal ideation was associated with depression (OR = 3.64) and negative perinatal-focused rumination (OR = 3.50). A four-group comparison based on insomnia status and high/low rumination revealed that pregnant women with insomnia and high rumination endorsed higher rates of depression (35.6%) and suicidal ideation (17.3%) than good-sleeping women with low rumination (1.2% depressed, 4.9% suicidal). Women with insomnia alone (depression: 3.9%, suicidal: 5.9%) or high rumination alone (depression: 10.7%, suicidal: 7.1%) did not differ from good-sleeping women with low rumination. CONCLUSIONS High rumination and insomnia are highly common in mid-to-late pregnancy and both are associated with depression and suicidal ideation. Depression and suicidal ideation are most prevalent in pregnant women with both insomnia and high rumination. CLINICALTRIALS. GOV IDENTIFIER NCT03596879.
Collapse
Affiliation(s)
- David A Kalmbach
- Thomas Roth Sleep Disorders & Research Center, Division of Sleep Medicine, Henry Ford Health System, Detroit, MI, 48202, USA.
| | - Philip Cheng
- Thomas Roth Sleep Disorders & Research Center, Division of Sleep Medicine, Henry Ford Health System, Detroit, MI, 48202, USA
| | - Jason C Ong
- Departments of Neurology and Psychiatry & Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA
| | - Jeffrey A Ciesla
- Department of Psychological Sciences, Kent State University, Kent, OH, 44240, USA
| | - Sheryl A Kingsberg
- Departments of Reproductive Biology and Psychiatry, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Roopina Sangha
- Department of Obstetrics & Gynecology, Henry Ford Health System, Detroit, MI, 48202, USA
| | - Leslie M Swanson
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Louise M O'Brien
- Departments of Obstetrics & Gynecology and Neurology, Ann Arbor, MI, 48105, USA
| | - Thomas Roth
- Thomas Roth Sleep Disorders & Research Center, Division of Sleep Medicine, Henry Ford Health System, Detroit, MI, 48202, USA
| | - Christopher L Drake
- Thomas Roth Sleep Disorders & Research Center, Division of Sleep Medicine, Henry Ford Health System, Detroit, MI, 48202, USA
| |
Collapse
|
33
|
Walker RL, Talavera DC, Nomamiukor F, Madubata IJ, Alfano C, Vujanovic AA. Sleep-related problems and suicide behavior and ideation among Black and White trauma-exposed psychiatric inpatients. Compr Psychiatry 2019; 91:22-28. [PMID: 30992121 DOI: 10.1016/j.comppsych.2019.03.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 02/05/2019] [Accepted: 03/11/2019] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Sleep-related problems (SRPs) are associated with increased risk for suicide-related behavior and death. Given that Black adults report greater SRPs as compared to White adults, the purpose of the current study was to examine sleep problems, suicide-related psychiatric admission, and suicide ideation, in Black and White trauma-exposed adults. METHOD Suicide-related behavior (i.e., intent, plan, and/or behavior) as reason for hospital admission was obtained via medical records review for 172 Black and White adults who were admitted to an acute-care psychiatric facility; all participants completed validated measures of sleep quality and suicide ideation. RESULTS Adjusted logistic regression analyses revealed that sleep-related daytime dysfunction (AOR = 4.32, p < .05) and poor sleep quality (AOR = 3.64, p < .05) were associated with significantly increased odds that Black participants were admitted for suicide-related psychiatric care. Poorer sleep quality (AOR = 2.10, p < .05) was also associated with increased odds of suicide-related admission among White participants. However, shorter sleep duration was marginally associated with suicide ideation in Black participants only. CONCLUSIONS SRPs may be related to suicide-related behavior and ideation differently for vulnerable Black and White adults. More research is needed to understand potential race group differences and mechanisms by which SRPs increase risk for suicide crisis across racial groups.
Collapse
Affiliation(s)
- Rheeda L Walker
- Department of Psychology, University of Houston, Houston, TX 30602-3013, USA.
| | - David C Talavera
- Department of Psychology, University of Houston, Houston, TX 30602-3013, USA; Harvard Medical School/Cambridge Health Alliance, Cambridge, MA 02139, USA
| | - Faith Nomamiukor
- Department of Psychology, University of Houston, Houston, TX 30602-3013, USA
| | - Ijeoma J Madubata
- Department of Psychology, University of Houston, Houston, TX 30602-3013, USA
| | - Candice Alfano
- Department of Psychology, University of Houston, Houston, TX 30602-3013, USA; Texas Institute for Measurement, Evaluation, and Statistics, University of Houston, Houston, TX 30602-3013, USA
| | - Anka A Vujanovic
- Department of Psychology, University of Houston, Houston, TX 30602-3013, USA
| |
Collapse
|
34
|
Guinhouya BC, Bisson M, Dubois L, Sériès F, Kimoff JR, Fraser WD, Marc I. Body Weight Status and Sleep Disturbances During Pregnancy: Does Adherence to Gestational Weight Gain Guidelines Matter? J Womens Health (Larchmt) 2019; 28:535-543. [DOI: 10.1089/jwh.2017.6892] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Benjamin C. Guinhouya
- Faculty of Health Sciences and Management and EA 2694, Public Health (Epidemiology and Healthcare Quality), University of Lille, Lille, France
- Department of Pediatrics, Research Center of CHUQ, Laval University, Quebec, Canada
| | - Michelle Bisson
- Department of Pediatrics, Research Center of CHUQ, Laval University, Quebec, Canada
| | - Lise Dubois
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Canada
| | - Frédéric Sériès
- Research Unit in Pneumology, Research Center, Laval University, Quebec, Canada
| | - John R. Kimoff
- Respiratory Division and Sleep Laboratory, McGill University Health Center, Montreal, Canada
| | - William D. Fraser
- Department of Obstetrics, Research Center of CHU de Sherbrooke, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Isabelle Marc
- Department of Pediatrics, Research Center of CHUQ, Laval University, Quebec, Canada
| |
Collapse
|
35
|
Prenatal sleep quality and mental health symptoms across the perinatal period: A longitudinal study of high-risk women. J Psychosom Res 2019; 116:31-36. [PMID: 30654991 DOI: 10.1016/j.jpsychores.2018.11.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 11/13/2018] [Accepted: 11/14/2018] [Indexed: 01/17/2023]
Abstract
BACKGROUND Trauma-exposed women may be at magnified risk for posttraumatic stress (PTSS) and depression symptoms in the perinatal period, but few studies have examined symptomatology across the perinatal period in high-risk samples. Further, the role of sleep in perinatal symptomatology has been largely neglected in the violence literature, despite its well-established associations to mental health in other samples. This study aimed to examine the trajectory of PTSS and depression symptoms across the perinatal period and the effects of childhood adversity, intimate partner violence and prenatal sleep impairment on PTSS and depression symptoms across the perinatal period. METHOD In a longitudinal, prospective study, 101 low-income pregnant women were interviewed during pregnancy, at 6-weeks postpartum, and 4 months postpartum. N = 83 women completed at least 2 interviews and were included in the analyses. Prenatal sleep, childhood adversity, and IPV exposure were assessed at the prenatal interview; PTSS and depression were assessed at all interviews. RESULTS Past year IPV was associated with elevated prenatal mental health symptoms and prenatal sleep difficulties were associated with a worsening trajectory in perinatal PTSS. CONCLUSIONS Screening for IPV and prenatal sleep difficulties may be paramount in identifying those at risk for the development or exacerbation of mental health symptoms in the perinatal period.
Collapse
|
36
|
Wang G, Deng Y, Jiang Y, Lin Q, Dong S, Song Y, Zhu L, Zhu Q, Sun W, Zhang Y, Jiang F. Trajectories of sleep quality from late pregnancy to 36 months postpartum and association with maternal mood disturbances: a longitudinal and prospective cohort study. Sleep 2018; 41:5238931. [DOI: 10.1093/sleep/zsy179] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Indexed: 12/21/2022] Open
Affiliation(s)
- Guanghai Wang
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institution, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Shanghai, China
| | - Yujiao Deng
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institution, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Shanghai, China
| | - Yanrui Jiang
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institution, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Shanghai, China
| | - Qingmin Lin
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institution, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Shanghai, China
| | - Shumei Dong
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institution, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Shanghai, China
| | - Yuanjin Song
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institution, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Shanghai, China
| | - Lixia Zhu
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institution, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Shanghai, China
| | - Qi Zhu
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institution, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Shanghai, China
| | - Wanqi Sun
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institution, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Shanghai, China
- Department of Psychology, Sleep Research Clinic and Laboratory, The University of Hong Kong, Pokfulam Road, Hong Kong, Hong Kong SAR
| | - Yunting Zhang
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institution, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Shanghai, China
| | - Fan Jiang
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institution, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Shanghai, China
| |
Collapse
|
37
|
Wang Y, Xia F, Wang W, Hu W. Assessment of sleep quality in benign paroxysmal positional vertigo recurrence. Int J Neurosci 2018; 128:1143-1149. [PMID: 29883234 DOI: 10.1080/00207454.2018.1486835] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Yun Wang
- Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Fei Xia
- Department of Otorhinolaryngology, Head and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing China
| | - Wei Wang
- Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Wenli Hu
- Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
38
|
Friedman LE, Manriquez Prado AK, Santos Malavé GF, Vélez JC, Gillibrand Esquinazi RW, Sanchez SE, Zhong QY, Gelaye B, Williams MA. Construct validity and factor structure of a Spanish-language Social Support Questionnaire during early pregnancy. Int J Womens Health 2018; 10:379-385. [PMID: 30050330 PMCID: PMC6055896 DOI: 10.2147/ijwh.s160619] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background The Social Support Questionnaire – Short Form (SSQ-6) is a widely used instrument that assesses availability and satisfaction of a person’s social support. The present study aimed to evaluate the construct validity and factor structure of the Spanish language version of the SSQ-6 during early pregnancy. Participants and methods A total of 4,236 pregnant Peruvian women were interviewed at 10.3 ± 3.8 weeks of gestation. In-person interviewers were used to collect lifestyle, demographic, and social support characteristics. The construct validity and factorial structure of the SSQ-6 were assessed through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The internal consistency was evaluated using Cronbach’s alpha. Results The mean SSQ-6 score was 39.6 ± 6.8 and Cronbach’s alpha was 0.83. EFA resulted in a three-factor solution that accounted for 60.6% of the variance. CFA results confirmed the three-factor structure and yielded measures indicating goodness of fit (comparative fit index of 0.9401) and accuracy (root mean square error of approximation of 0.0394). Conclusion Although the SSQ-6 was originally developed as a two-factor model, and previous studies have supported this, in our study a three-factor model was found to be more appropriate. The SSQ-6 was found to have good construct validity and reliability for assessing social support.
Collapse
Affiliation(s)
- Lauren E Friedman
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA,
| | - Ana Karen Manriquez Prado
- Multidisciplinary International Research Training Program, Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Gabriel Fidel Santos Malavé
- Multidisciplinary International Research Training Program, Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Juan Carlos Vélez
- Department of Rehabilitation, Hospital del Trabajador, Santiago, Chile
| | | | - Sixto E Sanchez
- Universidad Peruana de Ciencias Aplicadas, Lima, Peru.,Asociación Civil PROESA, Lima, Peru
| | - Qiu-Yue Zhong
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA,
| | - Bizu Gelaye
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA,
| | - Michelle A Williams
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA,
| |
Collapse
|
39
|
Ongeri L, McCulloch C, Neylan T, Bukusi E, Macfarlane S, Othieno C, Ngugi A, Meffert S. Suicidality and associated risk factors in outpatients attending a general medical facility in rural Kenya. J Affect Disord 2018; 225:413-421. [PMID: 28850856 PMCID: PMC5663198 DOI: 10.1016/j.jad.2017.08.059] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 08/10/2017] [Accepted: 08/20/2017] [Indexed: 01/02/2023]
Abstract
BACKGROUND Low-and-Middle-Income-Countries (LMICs) account for 75% of global suicides. While primary care populations in high-income countries (HIC) typically have higher prevalence of suicidal behavior relative to general populations, few studies have explored suicidal behavior among general medical outpatients in LMICs. This study addresses the research gap by characterizing potential risk factors for suicidal ideation in a large general medical outpatient setting in rural Kenya. METHODS A cross-sectional study of adult general medical outpatients attending a rural sub-county hospital in Kaloleni, Kenya. Primary outcomes included major depressive disorder (MDD), posttraumatic stress disorder (PTSD) and suicidal behavior measured by the Mini International Neuropsychiatric Interview (MINI 5.0). We use binary logistic regression to model suicidality, mental disorders, intimate partner violence, and lifetime abuse. RESULTS 394 outpatients completed the assessment. The prevalence of SI over the past month was 20%. 18% of those with suicidal ideation over the past month also attempted suicide in the past month. Participants who met criteria for MDD (suicidality item removed) were 19 times [CI: 4.56, 79.05] more likely to report suicidal ideation compared to those without MDD (adjusted odds ratio 12.15 [CI: 2.66, 55.49]). LIMITATIONS This was a cross sectional study design with convenience sampling and hence vulnerable to selection and recall bias. CONCLUSION The prevalence of SI and its strong association with actual suicide attempt in this population, make an urgent public health case for intervention. These data identify MDD as a highly significant correlate of SI.
Collapse
Affiliation(s)
- L. Ongeri
- Centre for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya,Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya,Corresponding author at: Centre for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya. (L. Ongeri)
| | - C.E. McCulloch
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA,Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - T.C. Neylan
- Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya,Department of Psychiatry, University of California San Francisco (UCSF), San Francisco, USA
| | - E. Bukusi
- Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya,Global Health Sciences, University of California San Francisco, California, USA
| | - S.B. Macfarlane
- Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya,Department of Psychiatry, University of Nairobi, Kenya
| | - C. Othieno
- Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya,Centre for Population Health Sciences, Faculty of Health Sciences-East Africa, Aga Khan University, Nairobi, Kenya
| | - A.K. Ngugi
- Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya,Department of Psychiatry, University of California San Francisco (UCSF), San Francisco, USA
| | - S.M. Meffert
- Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya,Department of Psychiatry, University of California San Francisco (UCSF), San Francisco, USA
| |
Collapse
|
40
|
Qian Y, Sun L, Zhou C, Ge D, Zhang L. The association between suicidal ideation and sleep quality in elderly individuals: A cross-sectional study in Shandong, China. Psychiatry Res 2017; 256:453-457. [PMID: 28709060 DOI: 10.1016/j.psychres.2017.07.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 06/21/2017] [Accepted: 07/09/2017] [Indexed: 10/19/2022]
Abstract
Previous studies have identified global associations between sleep quality and suicidal ideation. However, little is known regarding the relationship between sleep quality and suicidal ideation among Chinese older adults. We examined the relationship between sleep quality and suicidal ideation in older adults in China. A cross-sectional study was conducted in 3313 seniors in Shandong, China. Suicidal ideation was assessed using the interviewees' answers to the question "Have you ever seriously considered wanting to die?". Sleep quality was assessed using the Pittsburgh Sleep Quality Index. Logistic regression was performed to estimate odds ratios and 95% confidence intervals adjusted for confounders. When controlling for sex, age, living condition, economic status, marital status, education, past occupation, relationship with children, non-communicable diseases, and mental health, the odds of suicidal ideation increased in association with an increase in the total score for sleep quality and its components (subjective sleep quality, sleep duration, habitual sleep efficiency, and daytime dysfunction). Poor sleep quality was associated with increased odds of suicidal ideation in Chinese older adults. Sleep-based interventions should be developed to prevent suicide in older adults in China.
Collapse
Affiliation(s)
- Yangyang Qian
- School of Public Health, Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Long Sun
- School of Public Health, Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China.
| | - Chengchao Zhou
- School of Public Health, Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China.
| | - Dandan Ge
- School of Public Health, Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Li Zhang
- School of Public Health, Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| |
Collapse
|
41
|
Friedman LE, Aponte C, Perez Hernandez R, Velez JC, Gelaye B, Sánchez SE, Williams MA, Peterlin BL. Migraine and the risk of post-traumatic stress disorder among a cohort of pregnant women. J Headache Pain 2017; 18:67. [PMID: 28685258 PMCID: PMC5500599 DOI: 10.1186/s10194-017-0775-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 06/07/2017] [Indexed: 01/03/2023] Open
Abstract
Background Individually both migraine and post-traumatic stress disorder (PTSD) prevalence estimates are higher among women. However, there is limited data on the association of migraine and PTSD in women during pregnancy. Methods We examined the association between migraine and PTSD among women attending prenatal clinics in Peru. Migraine was characterized using the International Classification of Headache Disorders (ICHD)-III beta criteria. PTSD was assessed using the PTSD Checklist-Civilian Version (PCL-C). Multivariable logistic regression analyses were performed to estimate odds ratios (OR) and 95% confidence intervals (CI) after adjusting for confounders. Results Of the 2922 pregnant women included, 33.5% fulfilled criteria for any migraine (migraine 12.5%; probable migraine 21.0%) and 37.4% fulfilled PTSD criteria. Even when controlling for depression, women with any migraine had almost a 2-fold increased odds of PTSD (OR: 1.97; 95% CI: 1.64–2.37) as compared to women without migraine. Specifically, women with migraine alone (i.e. excluding probable migraine) had a 2.85-fold increased odds of PTSD (95% CI: 2.18–3.74), and women with probable migraine alone had a 1.61-fold increased odds of PTSD (95% CI: 1.30–1.99) as compared to those without migraine, even after controlling for depression. In those women with both migraine and comorbid depression, the odds of PTSD in all migraine categories were even further increased as compared to those women without migraine. Conclusion In a cohort of pregnant women, irrespective of the presence or absence of depression, the odds of PTSD is increased in those with migraine. Our findings suggest the importance of screening for PTSD, specifically in pregnant women with migraine. Electronic supplementary material The online version of this article (doi:10.1186/s10194-017-0775-5) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Lauren E Friedman
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, 677 Huntington Ave, K501, Boston, MA, 02115, USA.
| | - Christina Aponte
- Multidisciplinary International Research Training Program, Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Rigoberto Perez Hernandez
- Multidisciplinary International Research Training Program, Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Juan Carlos Velez
- Departamento de Rehabilitación, Hospital del Trabajador, Santiago, Chile
| | - Bizu Gelaye
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, 677 Huntington Ave, K501, Boston, MA, 02115, USA.,Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Sixto E Sánchez
- Universidad Peruana de Ciencias Aplicadas, Lima, Peru.,Asociación Civil PROESA, Lima, Peru
| | - Michelle A Williams
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, 677 Huntington Ave, K501, Boston, MA, 02115, USA
| | - B Lee Peterlin
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| |
Collapse
|
42
|
Sedov ID, Cameron EE, Madigan S, Tomfohr-Madsen LM. Sleep quality during pregnancy: A meta-analysis. Sleep Med Rev 2017; 38:168-176. [PMID: 28866020 DOI: 10.1016/j.smrv.2017.06.005] [Citation(s) in RCA: 278] [Impact Index Per Article: 39.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 05/31/2017] [Accepted: 06/09/2017] [Indexed: 10/19/2022]
Abstract
Women's sleep quality has been reported to change during pregnancy; prevalence estimates of poor sleep quality during pregnancy vary widely. To further understand the observed variation of findings, we conducted a meta-analysis to quantify the prevalence of poor sleep quality during pregnancy. Articles (N = 24) that reported prevalence of poor sleep quality as captured by the Pittsburgh sleep quality index (PSQI) ≥ 5 were included, with a total of 11,002 participants contributing data. PubMed, PsycINFO, and Web of Science databases were systematically searched. Results indicated that the average PSQI score during pregnancy was 6.07, 95% confidence interval (CI) [5.30, 6.85], and 45.7%, 95% CI [36.5%, 55.2%], of pregnant women experienced poor sleep quality. Longitudinal studies indicated that sleep quality decreased from second (M = 5.31, SE = 0.40) to third trimester (M = 7.03, SE = 0.85) by 1.68 points, 95% CI [0.42, 2.94]. Gestational age moderated the average PSQI scores and prevalence of PSQI scores ≥5; older samples reported higher mean PSQI scores and higher prevalence of poor sleep quality. Clinicians should be aware that some reduction in sleep quality is expected during pregnancy, but complaints of very poor sleep quality could require intervention. Future research should examine various factors underlying poor sleep quality during pregnancy.
Collapse
Affiliation(s)
- Ivan D Sedov
- Department of Psychology, University of Calgary, Calgary, AB, Canada.
| | - Emily E Cameron
- Department of Psychology, University of Calgary, Calgary, AB, Canada.
| | - Sheri Madigan
- Department of Psychology, University of Calgary, Calgary, AB, Canada; Alberta Children's Hospital Research Institute for Child and Maternal Health (ACHRI), Calgary, AB, Canada.
| | - Lianne M Tomfohr-Madsen
- Department of Psychology, University of Calgary, Calgary, AB, Canada; Alberta Children's Hospital Research Institute for Child and Maternal Health (ACHRI), Calgary, AB, Canada; Department of Pediatrics, Alberta Children's Hospital, Calgary, AB, Canada.
| |
Collapse
|
43
|
Poor sleep quality, antepartum depression and suicidal ideation among pregnant women. J Affect Disord 2017; 209:195-200. [PMID: 27930912 PMCID: PMC5360461 DOI: 10.1016/j.jad.2016.11.020] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 10/19/2016] [Accepted: 11/15/2016] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To evaluate the independent and combined associations of maternal self-reported poor sleep quality and antepartum depression with suicidal ideation during the third trimester METHODS: A cross-sectional study was conducted among 1298 pregnant women (between 24 and 28 gestational weeks) attending prenatal clinics in Lima, Peru. Antepartum depression and suicidal ideation were assessed using the Patient Health Questionnaire-9 (PHQ-9). The Pittsburgh Sleep Quality Index (PSQI) questionnaire was used to assess sleep quality. Multivariate logistical regression procedures were used to estimate odds ratios (OR) and 95% confidence intervals (95% CI) after adjusting for putative confounders. RESULTS Approximately, 17% of women were classified as having poor sleep quality (defined using the recommended criteria of PSQI global score of >5 vs. ≤5). Further, the prevalence of antepartum depression and suicidal ideation were 10.3% and 8.5%, respectively in this cohort. After adjusting for confounders including depression, poor sleep quality was associated with a 2.81-fold increased odds of suicidal ideation (OR=2.81; 95% CI 1.78-4.45). When assessed as a continuous variable, each 1-unit increase in the global PSQI score resulted in a 28% increase in odds for suicidal ideation, even after adjusting for depression (OR=1.28; 95% CI 1.15-1.41). The odds of suicidal ideation was particularly high among depressed women with poor sleep quality (OR=13.56 95% CI 7.53-24.41) as compared with women without either risk factor. LIMITATIONS This cross-sectional study utilized self-reported data. Causality cannot be inferred, and results may not be fully generalizable. CONCLUSION Poor sleep quality, even after adjusting for depression, is associated with antepartum suicidal ideation. Our findings support the need to explore sleep-focused interventions for pregnant women.
Collapse
|
44
|
The Relationship of Suicidal Thoughts and Behaviors to Sleep Disturbance: a Review of Recent Findings. CURRENT SLEEP MEDICINE REPORTS 2016. [DOI: 10.1007/s40675-016-0054-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
45
|
Gelaye B, Kajeepeta S, Williams MA. Suicidal ideation in pregnancy: an epidemiologic review. Arch Womens Ment Health 2016; 19:741-51. [PMID: 27324912 PMCID: PMC5023474 DOI: 10.1007/s00737-016-0646-0] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 06/02/2016] [Indexed: 10/21/2022]
Abstract
Suicidal behaviors are the leading causes of injury and death worldwide, and are leading causes of maternal deaths in some countries. One of the strongest risk factors, suicidal ideation, is considered a harbinger and distal predictor of later suicide attempt and completion, and also presents an opportunity for interventions prior to physical self-harm. The purpose of this systematic epidemiologic review is to synthesize available research on antepartum suicidal ideation. Original publications were identified through searches of the electronic databases using the search terms pregnancy, pregnant women, suicidal ideation, and pregnan* and suicid* as root searches. We also reviewed references of published articles. We identified a total of 2626 articles through the electronic database search. After irrelevant and redundant articles were excluded, 57 articles were selected. The selected articles were original articles that focused on pregnancy and suicidal ideation. Of the 57 included articles, 20 reported prevalence, 26 reported risk factors, 21 reported consequences of antepartum suicidal ideation, and 5 reported on screening measures. Available evidence indicates that pregnant women are more likely than the general population to endorse suicidal ideation. Additionally, a number of risk factors for antepartum suicidal ideation were identified including intimate partner violence, <12-year education, and major depressive disorder. There is a need for enhanced screening for antepartum suicidal ideation. The few screening instruments that exist are limited as they were primarily developed to measure antepartum and postpartum depression. Given a substantial proportion of women with suicidal ideation that does not meet clinical thresholds of depression and given the stress-diathesis model that shows susceptibility to suicidal behavior independent of depressive disorders, innovative approaches to improve screening and detection of antepartum suicidal ideation are urgently needed.
Collapse
Affiliation(s)
- Bizu Gelaye
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, 677 Huntington Ave, K505F, Boston, MA, 02115, USA.
| | - Sandhya Kajeepeta
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Michelle A. Williams
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA
| |
Collapse
|
46
|
Zhong QY, Wells A, Rondon MB, Williams MA, Barrios YV, Sanchez SE, Gelaye B. Childhood abuse and suicidal ideation in a cohort of pregnant Peruvian women. Am J Obstet Gynecol 2016; 215:501.e1-8. [PMID: 27173085 DOI: 10.1016/j.ajog.2016.04.052] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 04/11/2016] [Accepted: 04/29/2016] [Indexed: 01/22/2023]
Abstract
BACKGROUND Childhood abuse is a major global and public health problem associated with a myriad of adverse outcomes across the life course. Suicide is one of the leading causes of mortality during the perinatal period. However, few studies have assessed the relationship between experiences of childhood abuse and suicidal ideation in pregnancy. OBJECTIVE We sought to examine the association between exposure to childhood abuse and suicidal ideation among pregnant women. STUDY DESIGN A cross-sectional study was conducted among 2964 pregnant women attending prenatal clinics in Lima, Peru. Childhood abuse was assessed using the Childhood Physical and Sexual Abuse Questionnaire. Depression and suicidal ideation were assessed using the Patient Health Questionnaire-9 scale. Logistic regression procedures were performed to estimate adjusted odds ratios and 95% confidence intervals adjusted for potential confounders. RESULTS Overall, the prevalence of childhood abuse in this cohort was 71.8% and antepartum suicidal ideation was 15.8%. The prevalence of antepartum suicidal ideation was higher among women who reported experiencing any childhood abuse compared to those reporting none (89.3% vs 10.7%, P < .0001). After adjusting for potential confounders, including antepartum depression and lifetime intimate partner violence, those with history of any childhood abuse had a 2.9-fold (2.90, adjusted odds ratio; 95% confidence interval, 2.12-3.97) increased odds of reporting suicidal ideation. Women who experienced both physical and sexual childhood abuse had much higher odds of suicidal ideation (adjusted odds ratio, 4.04; 95% confidence interval, 2.88-5.68). Women who experienced any childhood abuse and reported depression had 3.44-fold (3.44, adjusted odds ratio; 95% confidence interval, 1.84-6.43) increased odds of suicidal ideation compared with depressed women with no history of childhood abuse. Finally, the odds of suicidal ideation increased with increased number of childhood abuse events experienced (P value for linear trend < .001). CONCLUSION Maternal history of childhood abuse was associated with increased odds of antepartum suicidal ideation. It is important for clinicians to be aware of the potential increased risk of suicidal behaviors among pregnant women with a history of childhood physical and sexual abuse.
Collapse
Affiliation(s)
- Qiu-Yue Zhong
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA.
| | - Anne Wells
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Marta B Rondon
- Department of Medicine, Cayetano Heredia Peruvian University, Lima, Peru
| | - Michelle A Williams
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Yasmin V Barrios
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Sixto E Sanchez
- Asociacion Civil Proyectos en Salud, Lima, Peru; Universidad Peruana de Ciencias Aplicados, Lima, Peru
| | - Bizu Gelaye
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA
| |
Collapse
|
47
|
Friedman LE, Gelaye B, Rondon MB, Sanchez SE, Peterlin BL, Williams MA. Association of Migraine Headaches With Suicidal Ideation Among Pregnant Women in Lima, Peru. Headache 2016; 56:741-9. [PMID: 27016264 DOI: 10.1111/head.12793] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Suicide is a leading cause of maternal death globally, and suicide prevalence rates have been shown to be increased in those with migraine. No previous study has examined the association between migraine and suicidal ideation during pregnancy. OBJECTIVE To examine the association between migraine and suicidal ideation among a cohort of pregnant women. METHODS A cross-sectional study was conducted among 3372 pregnant women attending prenatal care clinics in Lima, Peru. Suicidal ideation and depression were assessed using the Patient Health Questionnaire-9 (PHQ-9) scale during early pregnancy. Migraine classification (including migraine and probable migraine) was based on International Classification of Headache Disorders-III beta criteria. Multivariable logistic regression analyses were performed to estimate odds ratios (OR) and 95% confidence intervals (95% CI). RESULTS Suicidal ideation was more common among those with migraine (25.6%) as compared to those with probable migraine (22.1%, P < .001) or non-migraineurs (12.3%, P < .001). After adjusting for confounders, including depression, those with migraine or probable migraine had a 78% increased odds of suicidal ideation (OR = 1.78; 95% CI: 1.46-2.17), as compared with non-migraineurs. Women with both migraine and depression had a 4.14-fold increased odds of suicidal ideation (OR = 4.14; 95% CI: 3.17-5.42) compared to those with neither condition. CONCLUSION Migraine is associated with increased odds of suicidal ideation in pregnant women even when controlling for depression. These findings support the consideration of screening women with comorbid migraine and depression for suicidal behavior during pregnancy.
Collapse
Affiliation(s)
- Lauren E Friedman
- Harvard T. H. Chan School of Public Health - Epidemiology, Boston, MA, USA
| | - Bizu Gelaye
- Harvard T. H. Chan School of Public Health - Epidemiology, Boston, MA, USA
| | - Marta B Rondon
- Cayetano Heredia Peruvian University - Department of Medicine, Lima, Peru
| | - Sixto E Sanchez
- Asociación Civil Proyectos en Salud, Lima, Peru.,Universidad Peruana de Ciencias Aplicados, Lima, Peru
| | - B Lee Peterlin
- Johns Hopkins School of Medicine - Neurology, Baltimore, MD, USA
| | | |
Collapse
|
48
|
Construct validity and factor structure of the Pittsburgh Sleep Quality Index among pregnant women in a Pacific-Northwest cohort. Sleep Breath 2016; 20:293-301. [PMID: 26810497 DOI: 10.1007/s11325-016-1313-4] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 12/29/2015] [Accepted: 01/07/2016] [Indexed: 02/04/2023]
Abstract
PURPOSE Poor sleep quality during pregnancy is associated with adverse obstetric and neuropsychiatric outcomes. Despite its routine use as a sleep quality assessment scale among men and non-pregnant women, the psychometric properties of the Pittsburgh Sleep Quality Index (PSQI) have not been assessed among US pregnant women. We sought to evaluate the construct validity and factor structure of the PSQI among 1488 pregnant women. METHODS A structured interview was used to collect information about demographics and sleep characteristics in early pregnancy. The Patient Health Questionnaire-9 (PHQ-9) and the Depression, Anxiety, and Stress Scale-21 (DASS-21) were used to assess symptoms of depression, anxiety, and stress. Consistency indices, exploratory and confirmatory factor analyses (EFA and CFA), correlations, and logistic regression procedures were used. RESULTS The reliability coefficient, Cronbach's alpha for the PSQI items was 0.74. Results of the EFA showed that a rotated factor solution for the PSQI contained two factors with eigenvalues >1.0 accounting for 52.8 % of the variance. The PSQI was significantly positively correlated with the PHQ-9 (r s = 0.48) and DASS-21 (r s = 0.42) total scores. Poor sleepers (PSQI global score >5) had increased odds of experiencing depression (OR = 6.47; 95 % CI = 4.56-9.18), anxiety (OR = 3.59; 95 % CI = 2.45-5.26), and stress (OR = 4.37; 95 % CI = 2.88-6.65) demonstrating evidence of good construct validity. CFA results corroborated the two-factor structure finding from the EFA and yielded reassuring measures indicating goodness of fit (comparative fit index = 0.975) and accuracy (root mean square error of approximation = 0.035). CONCLUSIONS The PSQI has good construct validity and reliability for assessing sleep quality among pregnant women.
Collapse
|
49
|
Orsolini L, Valchera A, Vecchiotti R, Tomasetti C, Iasevoli F, Fornaro M, De Berardis D, Perna G, Pompili M, Bellantuono C. Suicide during Perinatal Period: Epidemiology, Risk Factors, and Clinical Correlates. Front Psychiatry 2016; 7:138. [PMID: 27570512 PMCID: PMC4981602 DOI: 10.3389/fpsyt.2016.00138] [Citation(s) in RCA: 99] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 07/25/2016] [Indexed: 11/13/2022] Open
Abstract
Perinatal period may pose a great challenge for the clinical management and treatment of psychiatric disorders in women. In fact, several mental illnesses can arise during pregnancy and/or following childbirth. Suicide has been considered a relatively rare event during the perinatal period. However, in some mental disorders (i.e., postpartum depression, bipolar disorder, postpartum psychosis, etc.) have been reported a higher risk of suicidal ideation, suicide attempt, or suicide. Therefore, a complete screening of mothers' mental health should also take into account thoughts of suicide and thoughts about harming infants as well. Clinicians should carefully monitor and early identify related clinical manifestations, potential risk factors, and alarm symptoms related to suicide. The present paper aims at providing a focused review about epidemiological data, risk factors, and an overview about the main clinical correlates associated with the suicidal behavior during the pregnancy and postpartum period. Practical recommendations have been provided as well.
Collapse
Affiliation(s)
- Laura Orsolini
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK; Villa San Giuseppe Hospital, Hermanas Hospitalarias, Ascoli Piceno, Italy; Polyedra Research Group, Teramo, Italy; Department of Psychiatry and Neuropsychology, University of Maastricht, Maastricht, Netherlands
| | - Alessandro Valchera
- Villa San Giuseppe Hospital, Hermanas Hospitalarias, Ascoli Piceno, Italy; Polyedra Research Group, Teramo, Italy
| | - Roberta Vecchiotti
- Villa San Giuseppe Hospital, Hermanas Hospitalarias, Ascoli Piceno, Italy; Polyedra Research Group, Teramo, Italy; Department of Psychiatry and Neuropsychology, University of Maastricht, Maastricht, Netherlands
| | - Carmine Tomasetti
- Polyedra Research Group, Teramo, Italy; Department of Mental Health ASL Teramo, Psychiatric Service of Diagnosis and Treatment, NHS, Hospital "Maria SS dello Splendore", Giulianova, Italy; Laboratory of Molecular and Translational Psychiatry, Department of Neuroscience, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Napoli, Italy
| | - Felice Iasevoli
- Polyedra Research Group, Teramo, Italy; Laboratory of Molecular and Translational Psychiatry, Department of Neuroscience, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Napoli, Italy
| | - Michele Fornaro
- Polyedra Research Group, Teramo, Italy; New York Psychiatric Institute, Columbia University, New York City, NY, USA
| | - Domenico De Berardis
- Polyedra Research Group, Teramo, Italy; Department of Mental Health ASL Teramo, Psychiatric Service of Diagnosis and Treatment, NHS, Hospital "G. Mazzini", Teramo, Italy; Department of Neuroscience and Imaging, University "G. d'Annunzio", Chieti, Italy
| | - Giampaolo Perna
- Department of Clinical Neurosciences, Hermanas Hospitalarias, FoRiPsi, Villa San Benedetto Menni, Albese con Cassano, Como, Italy; Department of Psychiatry and Behavioral Sciences, Leonard Miller School of Medicine, University of Miami, Coral Gables, FL, USA
| | | | | |
Collapse
|
50
|
Rice JR, Larrabure-Torrealva GT, Luque Fernandez MA, Grande M, Motta V, Barrios YV, Sanchez S, Gelaye B, Williams MA. High risk for obstructive sleep apnea and other sleep disorders among overweight and obese pregnant women. BMC Pregnancy Childbirth 2015; 15:198. [PMID: 26330183 PMCID: PMC4557601 DOI: 10.1186/s12884-015-0633-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 08/21/2015] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Obstructive sleep apnea (OSA), a common and serious disorder in which breathing repeatedly stops during sleep, is associated with excess weight and obesity. Little is known about the co-occurrence of OSA among pregnant women from low and middle-income countries. METHODS We examined the extent to which maternal pre-pregnancy overweight or obesity status are associated with high risk for OSA, poor sleep quality, and excessive daytime sleepiness in 1032 pregnant women in Lima, Peru. The Berlin questionnaire was used to identify women at high risk for OSA. The Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) were used to examine sleep quality and excessive daytime sleepiness, respectively. Multinomial logistic regression procedures were employed to estimate odds ratios (aOR) and 95% confidence intervals (CI) adjusted for putative confounding factors. RESULTS Compared with lean women (<25 kg/m(2)), overweight women (25-29.9 kg/m(2)) had 3.69-fold higher odds of high risk for OSA (95% CI 1.82-7.50). The corresponding aOR for obese women (≥30 kg/m(2)) was 13.23 (95% CI: 6.25-28.01). Obese women, as compared with their lean counterparts had a 1.61-fold higher odds of poor sleep quality (95% CI: 1.00-2.63). CONCLUSION Overweight or obese pregnant women have increased odds of sleep disorders, particularly OSA. OSA screening and risk management may be indicated among pregnant women in low and middle income countries, particularly those undergoing rapid epidemiologic transitions characterized by increased prevalence of excessive adult weight gain.
Collapse
Affiliation(s)
- Jayne R Rice
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, K501, Boston, MA, , 02115, USA.
| | - Gloria T Larrabure-Torrealva
- Instituto Nacional Materno Perinatal de Lima, Lima, Peru. .,Departamentos de Medicina y Ginecología y Obstetricia Universidad Nacional Universidad Nacional Mayor de San Marcos, Lima, Peru.
| | - Miguel Angel Luque Fernandez
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, K501, Boston, MA, , 02115, USA.
| | - Mirtha Grande
- Asociación Civil de Proyectos en Salud, AC.PROESA, Lima, Peru.
| | - Vicky Motta
- Instituto Nacional Materno Perinatal de Lima, Lima, Peru.
| | - Yasmin V Barrios
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, K501, Boston, MA, , 02115, USA.
| | - Sixto Sanchez
- Universidad de Ciencias Aplicadas, Lima, Peru. .,Asociación Civil de Proyectos en Salud, AC.PROESA, Lima, Peru.
| | - Bizu Gelaye
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, K501, Boston, MA, , 02115, USA.
| | - Michelle A Williams
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, K501, Boston, MA, , 02115, USA.
| |
Collapse
|